A Randomized Study of Postoperative Pain Comparing between Coblation and Electrosurgical Tonsillectomy

Abstract

A Randomized Study of Postoperative Pain Comparing between Coblation and Electrosurgical Tonsillectomy

Pichai    Puapermpoonsiri    MD

Department of Otolaryngology, BMA Medical College and Vajira Hospital

Objective: To compare postoperative pain between coblation and electrosurgical tonsillectomy.

Study design: A prospective double-blind randomized controlled trial.

Subjects: Thirty two patients of BMA Medical College and Vajira Hospital, who were indicated to have tonsillectomy.

Methods: Patients were randomly allocated from the number in the sealed envelope to have tonsillectomy on the left or the right side first and then were allocated to have either coblation tonsillectomy or electrosurgical tonsillectomy on the first side, and the other method in the remaining side. Hence, each patient would have coblation tonsillectomy on one side and electrosurgical tonsillectomy on the other side. Patients and the nurses who evaluated pain score were blinded for the operation method. The length of the procedure, intraoperative blood loss, the postoperative pain at 24, 48 hours and 14 days and the postoperative complications were recorded.

Main outcome measures: Postoperative pain at 24, 48 hours and on day 14 evaluated by visual analogue pain score, length of the procedure, intraoperative blood loss, and the postoperative complications.

Results: From 32 patients, 14 were male and 18 were female. The mean age was 30.7 + 9.2 years. Postoperative pain from coblation tonsillectomy was significantly less than electrosurgical tonsillectomy at 24 hours (5.2 + 0.6 vs 5.8 + 0.9). No statistical significant difference on post-operative pain at 48 hours and on day 14, length of procedure and intraoperative blood loss between the two methods. Postoperative complication was not encountered in both methods.

Conclusion: Coblation tonsillectomy causes significantly less pain during the first postoperative day. No demonstrable benefit was shown on day 2 and 14. The beneficial effect of coblation on the first day postoperative pain makes it a potentially attractive technique for tonsillectomy.

Key words: tonsillectomy, coblation, electrosurgery, postoperative pain

Vajira Med J 2009 ; 54 : 3 - 8