Fibrin sealant reduces pain after tonsillectomy: prospective randomized study.
OBJECTIVE
Postsurgical pain in adults following tonsillectomy with fibrin sealant or electrocoagulation was assessed by surface electromyography (sEMG), a dysphagia severity rating scale (DSRS), and a visual analog scale (VAS) pain


METHODS
For group 1 (n = 40), hemostasis was achieved by fibrin sealant spraying to the tonsillar fossae. For group 2 (n = 40), hemostasis was achieved by bipolar or needle point electrocautery. The timing of single swallowing and continuous drinking and the mean electrical activity of the masseter, infrahyoid, and submental-submandibular muscles were compared with a normative database during 30 days and with DSRS and VAS scores.


RESULTS
Electrical activity of the masseter and infrahyoid muscles was significantly higher in both groups in comparison with the normative database (p < .05 to p < .005), whereas timing was less affected. The combined sEMG, DSRS, and VAS assessment showed that tonsillectomy ended with sealant causes less pain than electrocoagulation (p < .05). The DSRS score data were in strong positive correlation with the sEMG records, whereas the VAS pain score was less informative.


CONCLUSIONS
The combined sEMG and pain score data indicate that the electrocautery hemostatic technique is more painful and traumatic than the sealant technique. Surface electromyography of swallowing is a simple, reliable evaluation method for postsurgical odynophagia complaints and might be used as an objective tool for pain assessment.
Vaiman
Michael
M
Department of Otolaryngology, Assaf Harofe Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Krakovski
Daniel
D
Gavriel
Haim
H
D000328:Adult; D004576:Electromyography; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008406:Masseter Muscle / Q000503:physiopathology; D009119:Muscle Contraction; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D014014:Tissue Adhesives / Q000627:therapeutic use*; D014068:Tonsillectomy; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives