title: A comparison of tonsillectomy with the harmonic scalpel versus electrocautery.
abstract: 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.
authors.affiliation: Central DuPage Hospital, Winfield, IL 60190, USA.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Morgenstein
authors.forename: H Kurt
authors.initials: HK
authors.lastname: Jacobs
authors.forename: Peter A
authors.initials: PA
authors.lastname: Brusca
authors.forename: Angelo R
authors.initials: AR
authors.lastname: Consiglio
authors.forename: Joseph
authors.initials: J
authors.lastname: Donzelli
authors.forename: James A
authors.initials: JA
authors.lastname: Jakubiec
authors.forename: Terry L
authors.initials: TL
authors.lastname: Donat
mesh_terms: 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