A comparison of tonsillectomy with the harmonic scalpel versus electrocautery.
OBJECTIVE
We sought to test whether the use of the harmonic scalpel would cause less pain and more rapid recovery in tonsillectomy patients versus the use of electrocautery.


METHODS
In a private practice community hospital, we conducted a prospective nonrandomized comparison of 156 pediatric tonsillectomy cases. Local anesthetic infiltrations and steroids were used at the discretion of the surgeon. Outcome variables consisted primarily of immediate- and mid-term pain, pain medications required, time to eating, morbidities and charges.


RESULTS
There were no differences between the groups on an intention-to-treat basis except for costs, which were higher in the harmonic scalpel group. When rescue use of electrocautery was required to control bleeding in the in the harmonic scalpel patients, more pain and longer times to taking food were noted.


CONCLUSIONS
Used with discretion the harmonic scalpel is equivalent to electrocautery for tonsillectomy.


CONCLUSIONS
The harmonic scalpel does not provide a major benefit over more conventional methods of tonsillectomy.
Morgenstein
Stuart A
SA
Central DuPage Hospital, Winfield, IL 60190, USA.
Jacobs
H Kurt
HK
Brusca
Peter A
PA
Consiglio
Angelo R
AR
Donzelli
Joseph
J
Jakubiec
James A
JA
Donat
Terry L
TL
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013525:Surgical Instruments; D014068:Tonsillectomy / Q000295:instrumentation* / Q000379:methods