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Intrapatient Comparison of Coblation versus Electrocautery Tonsillectomy in Children: A Randomized, Controlled Trial
Kyu Young Choi1, Jae-Cheul Ahn2, Chae-Seo Rhee3,4,5,6
1Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea.
Insights
Coblation tonsillectomy significantly reduces postoperative pain in children compared to electrocautery. This surgical technique offers improved pain management and enhanced quality of life for pediatric patients undergoing tonsillectomy.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Pain Management
Background:
- Tonsillectomy is a common pediatric surgical procedure.
- Various surgical instruments are used, with varying safety and efficiency profiles.
- Postoperative pain is a significant concern following tonsillectomy.
Purpose of the Study:
- To compare postoperative pain between coblation tonsillectomy and conventional monopolar electrocautery tonsillectomy.
- To evaluate pain using an intrapatient comparison in pediatric patients.
- To assess the impact on the pediatric postoperative quality of life.
Main Methods:
- A prospective study involving 30 pediatric patients (age > 6 years).
- Intrapatient comparison: one tonsil removed by coblation, the other by electrocautery.
- Pain assessment using the Visual Analogue Scale (VAS) for 10 days post-surgery.
Main Results:
- 73% of patients reported less pain on the coblation side on the day of surgery.
- Mean postoperative pain scores were significantly lower on the coblation side for most of the 10-day period.
- Duration of severe pain (VAS > 5) was shorter with coblation (2.0 days) versus electrocautery (3.7 days).
Conclusions:
- Coblation tonsillectomy results in less postoperative pain compared to electrocautery in pediatric patients.
- Coblation may be a preferred surgical instrument for tonsillectomy to improve pediatric patient outcomes.
- This technique can enhance the postoperative quality of life for children.
Abstract:
Many surgical instruments have been introduced and compared for safety and surgical efficiency in tonsillectomy. This study aimed to compare postoperative pain between coblation and conventional monopolar electrocautery tonsillectomy by intrapatient comparison in children. Thirty pediatric patients over six years of age undergoing tonsillectomies were enrolled. Coblation and electrocautery were used to remove both tonsils in one patient; one was removed by coblation and the other by electrocautery. The coblation side was randomly selected, and it was blinded to the patients. Each side’s daily pain scores were collected on the visual analogue scale (VAS) during ten postoperative days. On the day of surgery, 22 (73%) patients identified less pain on the coblation side, while others felt similar pain. The mean pain scores were significantly lower on the coblation side during the postoperative ten days (except for the 6th and 8th) than on the electrocautery side. The duration of severe pain (VAS > 5) was significantly shorter on the coblation side than on the electrocautery side (2.0 versus 3.7 days, respectively; p = 0.042). Coblation tonsillectomy induced less pain than electrocautery in pediatric patients; therefore, surgeons could choose the coblator as a surgical instrument for tonsillectomy to improve the pediatric postoperative quality of life.
