Intracapsular vs. extracapsular tonsillectomy: a comparison of pain.
OBJECTIVE
To measure differences in postoperative pain in children undergoing intracapsular tonsillectomy vs. extracapsular tonsillectomy.


METHODS
Prospective clinical trial carried out at a tertiary children's hospital over 1 year.


METHODS
The study included 43 patients age 5 to 19 years with adenotonsillar hypertrophy, 27 undergoing extracapsular tonsillectomy and 16 undergoing intracapsular tonsillectomy. Tonsillectomy was performed in either an intracapsular or extracapsular fashion using bipolar electrosurgical scissors and monopolar suction cautery for hemostasis. Residents under faculty supervision performed all operations. Postoperative pain was assessed using the Wong-Baker Faces Pain Scale through postoperative day 10. The patients recorded in a standardized diary pain scores and analgesic use. The main outcome measure was postoperative pain as measured by the Wong-Baker Faces Pain Scale. The quantity of postoperative pain medicine consumed was a secondary outcome measure.


RESULTS
Average postoperative pain for extracapsular tonsillectomy was 5.21 on a 10-point scale versus 2.75 for intracapsular tonsillectomy (P < .0001).


CONCLUSIONS
Intracapsular tonsillectomy with bipolar scissors results in less postoperative pain than extracapsular tonsillectomy with bipolar scissors in children age 5 to 19 years.
Cohen
Michael S
MS
Department of Otolaryngology-Head and Neck Surgery, Temple University Children's Medical Center, School of Medicine, Philadelphia, PA 19140, USA.
Getz
Anne E
AE
Isaacson
Glenn
G
Gaughan
John
J
Szeremeta
Wasyl
W
D000234:Adenoids / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D014066:Palatine Tonsil / Q000473:pathology / Q000601:surgery; D011446:Prospective Studies; D012720:Severity of Illness Index; D014068:Tonsillectomy / Q000706:statistics & numerical data*