Methods of Haemostasis in Tonsillectomy Assessed by Pain Scores and Consultation Rates: The Roskilde County Tonsillectomy Study

Abstract

Rungby JA, Rømeling F, Borum P. Methods of haemostasis in tonsillectomy assessed by pain scores and consultation rates. Acta Otolaryngol 2000; Suppl 543: 209-214.Objecti6es: To compare four methods of haemostasis after tonsillectomy assessed by pain scores and consultation rates. Study design and methods: A prospective study. The method of sole compression of the tonsillar fossae with gauze tampons was compared to ligation, bipolar diathermy and ligation/diathermy in combination. Results: Highly significantly lower pain scores after discharge were found in the compression group compared to the other three groups (pB 0.025). The consultation rate in person after discharge of the compression group was significantly lower than in the diathermy group (p B0.01) and the ligation/diathermy group (p B0.05). Conclusion: Sole compression was associated with considerably less morbidity and no higher risk of postoperative haemorrhage. Sole compression should therefore be preferred in tonsillectomy whenever the surgeon considers it to be justified.

Harmonic Scalpel Tonsillectomy in Children: A Randomized Prospective Study

“…The interruption in the decline in throat pain over this time period may also be accounted for by the return to a normal diet, with concomitant increase in swallowing that occurs as the child convalesces 19 . Our finding of a plateau in the pain relief curve over postoperative days 4 through 6 was similar to that seen in other clinical trials, regardless of the techniques and tools used 19,20 …”

“…19 Our finding of a plateau in the pain relief curve over postoperative days 4 through 6 was similar to that Otolaryngology-Head and Neck Surgery seen in other clinical trials, regardless of the techniques and tools used. 19,20 In this study, there was a trend for mean postoperative pain scores to be lower for HS subjects than for EC subjects. Although pain scores were not statistically significant, the ability to sleep was statistically significant.…”

Comparison Benefit between Hydrogen Peroxide and Adrenaline in Tonsillectomy: A Randomized Controlled Study

“…Hemostasis with the compression of a cotton ball may also cause lower postoperative pain than bipolar cauterization and ligation 19 . Topical hemostatic agents can also prevent sloughing of the eschar and help control mucosal bleeding across surface areas.…”

Making sense out of the tonsillectomy literature

“…Thirteen (27%) of the 49 ''cold knife'' studies also had a stated non-thermal method of hemostasis [1,[6][7][8][9][10][11][12][13][14][15][16]. Twenty-seven (55%) of the 49 studies that used a cold knife dissection technique, also used a ''hot'' hemostasis technique.…”