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Postoperative Pain and 14-Day Recovery in Children Undergoing Adenotonsillectomy: Low Thermal Damage Device Versus

Kathryn V Blake1,2, Jobayer Hossain3, Brett Chafin4,5,6

  • 11 Center for Pharmacogenomics and Translational Research, Nemours Children's Specialty Care, Jacksonville, FL, USA.

Ear, Nose, & Throat Journal
|April 4, 2019
PubMed

Insights

A low thermal damage device significantly reduces postoperative pain medication needs in children compared to traditional electrosurgery for adenotonsillar hypertrophy. This finding offers a less painful recovery for pediatric patients undergoing these common procedures.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Pain Management

Background:

  • Obstructive sleep-disordered breathing and recurrent adenotonsillitis are common in children.
  • Adenotonsillar hypertrophy is a frequent cause, often treated with surgical removal.
  • Traditional electrosurgery carries risks of significant postoperative pain and medication requirements.

Purpose of the Study:

  • To compare the efficacy of a low thermal damage device versus traditional electrosurgery in managing postoperative pain.
  • To evaluate pain scores and medication usage in pediatric patients undergoing tonsillectomy or adenoidectomy.

Main Methods:

  • Randomized controlled trial involving 75 children aged 3-17 years.
  • Comparison of low thermal damage device and traditional electrosurgery.
  • Postoperative pain assessment using the Wong-Baker FACES pain scale for 14 days.
  • Tracking of pain medication doses and time to pain resolution.

Main Results:

  • No significant difference in the rate of pain score decrease between the two devices.
  • A significant interaction was found between pain decrease rate and pain medication doses (P < .0001).
  • Median pain medication doses were significantly lower with the low thermal device (21) compared to electrosurgery (36; P = .001).
  • Pain scores resolved to zero after a median of 7 days for the low thermal device versus 9 days for electrosurgery (P = .67).
  • One patient in the electrosurgery group was hospitalized for postoperative bleeding.

Conclusions:

  • Low thermal damage devices result in significantly less postoperative pain medication use in children compared to traditional electrosurgery.
  • While pain scores decrease similarly, the reduced need for analgesia suggests a benefit for the low thermal device in pediatric adenotonsillectomy recovery.
  • Further research may explore long-term outcomes and cost-effectiveness.

Keywords:
adenotonsillectomyelectrosurgerylow thermal damage devicepainpediatric

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