A prospective randomized single-blind trial comparing ultrasonic scalpel tonsillectomy with tonsillectomy by blunt dissection in a pediatric age group.
OBJECTIVE
To determine if there was a difference in postoperative pain and dietary intake when comparing ultrasonic scalpel (US) with blunt dissection tonsillectomy (BD) in children.


METHODS
A prospective single-blind randomized controlled trial comparing US and BD tonsillectomy in children aged between 5 and 13 years who undergo tonsillectomy for recurrent acute tonsillitis in a specialized pediatric hospital.


RESULTS
One hundred and twenty-two children were enrolled. Ninety-three (76%) patients completed dietary and pain scales. Pain was significantly greater in the US group on postoperative days 1 and 3 (P = 0.0466, P = 0.0084) and overall (P = 0.0003). Dietary intake scores were significantly better in the US group on days 1, 5, 7, and 9, however, these scores were inconsistent with dietary intake scores declining in both groups throughout the study. Blood loss was statistically significantly greater in the BD group (33.1 ml vs 3.0 ml, P < 0.0001). There were no significant differences for all other observed outcomes.


CONCLUSIONS
US tonsillectomy causes significantly more pain overall and on postoperative days 1 and 3 when compared to BD tonsillectomy. US tonsillectomy causes less intraoperative blood loss, the clinical significance of which is questionable.


CONCLUSIONS
US tonsillectomy appears to cause more postoperative pain than BD tonsillectomy in children aged 5 to 13 years undergoing tonsillectomy for recurrent acute tonsillitis.
Oko
Michael O
MO
Department of Otolaryngology, Royal Hospital for Sick Children, Yorkhill, UK.
Ganly
Ian
I
Loughran
Sean
S
Clement
W Andrew
WA
Young
David
D
Geddes
Neil K
NK
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004032:Diet; D004435:Eating; D006801:Humans; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D011446:Prospective Studies; D020127:Recovery of Function; D016037:Single-Blind Method; D013997:Time Factors; D014068:Tonsillectomy / Q000009:adverse effects* / Q000379:methods*; D014069:Tonsillitis / Q000601:surgery*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000009:adverse effects* / Q000295:instrumentation*