A pilot randomized controlled trial of coblation tonsillectomy versus dissection tonsillectomy with bipolar diathermy haemostasis.
OBJECTIVE
To compare postoperative recovery in children between 4 and 12 years undergoing tonsillectomy, using either coblation tonsillectomy or dissection tonsillectomy with bipolar diathermy haemostasis.


METHODS
A prospective, single blind, randomised controlled trial.


METHODS
ENT clinic, University Teaching Hospital.


METHODS
Forty paediatric patients, aged between 4 and 12 years and between 16 and 60 kg in weight with standard indication for tonsillectomy.


METHODS
Patients were randomly allocated to either coblation tonsillectomy or dissection tonsillectomy groups. Patients, parents, and nurses were blinded for operation method. Parents were asked to fill out a postoperative diary from 1 to 10 days.


METHODS
Primary outcomes were scored for postoperative pain, nutrition, activity, and use of analgetics for each of the 10 postoperative days. Secondary outcomes were estimated from the nurses' postoperative data and 10-day follow-up statistics regarding crossing of the two-score limit.


RESULTS
The groups were statistically comparable by age, weight and operation type. There was no significant difference in operation time in two groups. Intra-operative bleeding was significantly less in the coblation group. Statistically significant differences between dissection tonsillectomy and coblation tonsillectomy were found in the day when a score of two of five was passed in pain scores (9.6 versus 6.2), nutrition scores (8.9 versus 6.6), activity score (8.4 versus 6.6) and medicine intake (9.4 versus 6.4), We found parallelism, between regression lines, that indicates better postoperative life quality for the coblation tonsillectomy group and approximately 2 days' shorter recovery time.


CONCLUSIONS
In our pilot study, patients undergoing coblation tonsillectomy reported less pain, quicker return to normal diet, quicker return to normal activity, and less use of analgetics over a 10-day period than patients undergoing dissection tonsillectomy. Our results indicate that the recovery period for coblation tonsillectomy was approximately 2 days shorter and demonstrated less morbidity.
Mitic
S
S
ENT Department, Akershus University Hospital, Oslo, Norway. smitic@online.no
Tvinnereim
M
M
Lie
E
E
Saltyte
B J
BJ
D000700:Analgesics / Q000008:administration & dosage; D016009:Chi-Square Distribution; D002648:Child; D003972:Diathermy / Q000379:methods*; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008297:Male; D009752:Nutritional Status; D010147:Pain Measurement; D010865:Pilot Projects; D011183:Postoperative Complications; D011446:Prospective Studies; D012044:Regression Analysis; D018709:Statistics, Nonparametric; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome
D000700:Analgesics