Effect of diathermy on pain and healing in tonsillectomy, compared with other methods of haemostasis: a randomised study.
OBJECTIVE
To compare three methods of haemostasis used for 'cold steel' tonsillectomy, in terms of pain scores and morbidity.


METHODS
Prospective, randomised, single-blinded, controlled clinical study. Three haemostasis methods were compared: compression of the tonsillar fossae with gauze packs; bipolar diathermy; and local anaesthesia then pack compression. The outcome measures were pain scores (derived from a visual analogue scale), peri-operative bleeding, and post-operative episodes of blood-stained saliva, consultation rate, tonsillar bed healing and days before return to regular diet. One hundred and five patients were included.


RESULTS
Peri-operative bleeding was significantly reduced in the local anaesthesia group compared with the other two groups. Delayed post-operative tonsillar bed healing was noted in the diathermy group. No other significant differences were found between the three haemostasis groups, for any other outcome measures. The presence of blood-stained saliva was associated with higher pain scores.


CONCLUSIONS
Diathermy and compression were associated with similar post-tonsillectomy morbidity.
Department of Otorhinolaryngology, University of Copenhagen, Gentofte Hospital, Copenhagen, Denmark. hojde@c.dk
C H
CH
Hahn
J A
JA
Rungby
T
T
Overgaard
H
H
Møller
P
P
Schultz
M
M
Tos
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003972:Diathermy / Q000379:methods*; D005260:Female; D006489:Hemostatic Techniques / Q000295:instrumentation; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011446:Prospective Studies; D016037:Single-Blind Method; D014068:Tonsillectomy; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult