Randomized controlled trial of Coblation versus electrocautery tonsillectomy.
OBJECTIVE
To compare the postoperative recovery of patients receiving Coblation-assisted (Arthrocare, Sunnyvale, CA) intracapsular tonsillectomy with that of patients receiving traditional subcapsular electrocautery tonsillectomy.


METHODS
This was a prospective, randomized, double-blinded, controlled study. One hundred one children, aged 2 to 16 years, were randomized to Coblation or to conventional electrocautery tonsillectomy. Only patients with the operative indication of obstructive sleep apnea were entered into the study. Intracapsular tonsillectomy was performed on the Coblation group, and traditional subcapsular dissection was performed on the electrocautery group. Adenoidectomy was performed with the curette in both groups. Outcome measures were assessed on days 1, 3, and 5 after surgery. These included child and parental rating of pain by using the Wong Faces pain scale, analgesic use, oral intake, and activity level. Patients, parents, and the nurse practitioner obtaining the outcome data were blinded to treatment arm.


RESULTS
Treatment groups were similar in age, gender, and weight. Surgical time and estimated blood loss were similar. There were no complications in either group. Coblation patients had less pain and greater oral intake at all 3 time points. Percentage of normal activity level returned to >70% earlier and more frequently in Coblation patients. There was slightly decreased analgesic use on postoperative day 5 in the Coblation group.


CONCLUSIONS
Children with obstructive sleep apnea undergoing tonsillectomy and adenoidectomy demonstrate significantly better postoperative recovery after Coblation-assisted intracapsular tonsillectomy.
Chang
Kay W
KW
Division of Pediatric Otolarnygology, Lucile Packard Children's Hospital at Stanford, CA, USA. kchang@stanfordmed.org
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003452:Cryosurgery; D004311:Double-Blind Method; D004564:Electrocoagulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010147:Pain Measurement; D011446:Prospective Studies; D020127:Recovery of Function; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D013997:Time Factors; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome