Harmonic scalpel tonsillectomy in children: a randomized prospective study.
OBJECTIVE
In this randomized prospective study, we evaluated postoperative morbidity after use of the Harmonic Scalpel (HS), an ultrasonic dissector coagulator (Ethicon Endo-Surgery Inc, Cincinnati, OH), or conventional electrocautery (EC) during tonsillectomy.


METHODS
Pediatric subjects at 2 sites were randomized and underwent tonsillectomy. Intraoperative blood loss and operation duration were recorded. Postoperative parameters and complications were recorded.


RESULTS
One hundred seventeen subjects completed the study. For the HS group, mean operative time was significantly longer (P < 0.001), but intraoperative blood loss was equivalent (P = 1.000). HS subjects slept soundly on postoperative days 1, 2, 3, and 14 (P = 0.041, 0.013, 0.022, and 0.038, respectively, compared with EC group). Mean postoperative pain scores trended lower for HS subjects on postoperative days 2, 3, and 4.


CONCLUSIONS
The use of the HS in pediatric tonsillectomy showed no increase in intraoperative or postoperative blood loss compared with the use of EC, and HS provided possible clinical advantages over EC in patient comfort.


CONCLUSIONS
Tonsillectomy subjects in the HS group showed a statistically significant ability to sleep soundly, suggesting that the subjects experienced less pain. These data correlate with the observed decrease in pain scores.
Willging
J Paul
JP
Cincinnati Children's Hospital Medical Center, Ohio, USA.
Wiatrak
Brian J
BJ
D016063:Blood Loss, Surgical; D002648:Child; D002675:Child, Preschool; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain; D011446:Prospective Studies; D016037:Single-Blind Method; D014068:Tonsillectomy / Q000295:instrumentation*; D014465:Ultrasonics