Comparison of posttonsillectomy pain using the ultrasonic scalpel, coblator, and electrocautery.
OBJECTIVE
To compare postoperative tonsillectomy pain between 3 commonly used surgical devices: the Harmonic Ultrasonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH), the Coblator (ArthroCare Corp, Sunnyvale, CA), and electrocautery.


METHODS
A prospective, randomized trial. One hundred thirty-four patients were randomly assigned to receive a tonsillectomy with 1 of 3 surgical devices. All patients were asked to fill out a postoperative diary.


RESULTS
Statistically significant differences in pain scores were revealed between the Coblator and electrocautery (P = 0.02) and between the Coblator and the Ultrasonic Scalpel (P = 0.003), with the Coblator having lower pain scores. Electrocautery and the Ultrasonic Scalpel did not differ significantly from each other. The Coblation method showed a strong trend toward quicker return to normal diet.


CONCLUSIONS
Patients undergoing tonsillectomy with the Coblator device reported less pain over a 10-day period than patients undergoing tonsillectomy with electrocautery or the Ultrasonic Scalpel. Pain after tonsillectomy remains a major issue for our patients. The choice of surgical instrument appears to be one way to reduce this pain.


METHODS
A-1b.
Parsons
Stephen P
SP
Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, 699 West Drive, Indianapolis, IN 46202, USA. stparson@iupui.edu
Cordes
Susan R
SR
Comer
Brett
B
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004435:Eating; D004564:Electrocoagulation / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D011446:Prospective Studies; D011846:Radio Waves; D020127:Recovery of Function; D014068:Tonsillectomy / Q000009:adverse effects* / Q000295:instrumentation*; D014465:Ultrasonics