Comparison of Postoperative Pain in Pediatric Patients Undergoing Coblation Tonsillectomy versus Cautery Tonsillectomy

Abstract

Pediatric pain is similar following monopolar electrocautery or coblation subcapsular tonsillectomy.

Impact of coblation versus electrocautery on acute post‐operative outcomes in pediatric tonsillectomy

“…Given the findings of our study and other studies that have shown no significant difference in pain between these techniques, we ask the question of whether the cost of coblation can be justified . As health care costs shift from insurance companies to hospitals and physicians, physicians must become more accountable for the costs of their decisions, including equipment .…”

“…Post‐operative pain can continue for up to 2 weeks and can lead to decreased oral intake and dehydration requiring hospital readmission . Despite many prospective studies comparing these methods to determine which one causes less post‐operative pain, there is not a clear consensus …”

“…Parsons et al showed a significant difference in pain scores in children across a 10‐day period but did not compare daily scores . Jones et al reported statistically significantly lower pain scores in coblation patients only on postoperative day 0, but the authors suggested that the small difference they detected was not clinically significant . Shah et al reported similar pain scores, morphine consumption, and time to return to normal function with coblation and electrocautery in pediatric tonsillectomy patients…”

“…There have been several studies comparing pain outcomes with coblation versus conventional methods of tonsillectomy, particularly electrocautery. Results within pediatric populations have varied greatly, with some studies reporting better pain control after coblation as compared to electrocautery, while other studies, including Cochrane reviews, have found no significant difference . Additionally, Jones et al found a small but statistically significant difference in pain scores, but suggested that the difference was not clinically significant and that neither method is superior with regard to postoperative pain …”

The utility of common surgical instruments for pediatric adenotonsillectomy

“…Alternatively, bipolar radiofrequency ablation (coblation) significantly limits thermal heat to 40°C to 70°C through the use of irrigating saline and its bipolar component, providing a theoretical decrease in collateral tissue damage. Although several studies suggest a decreased need for postoperative analgesia with intracapsular coblation techniques, a recent Cochrane review concluded the evidence supporting decreased postoperative pain with radiofrequency ablation to be inadequate . Other reports examining radiofrequency ablation have cited an increase in postoperative hemorrhage and surgical costs .…”