title: Prospective comparative study of pulsed-electron avalanche knife (PEAK) and bipolar radiofrequency ablation (coblation) pediatric tonsillectomy and adenoidectomy.
abstract: OBJECTIVE
  To compare post-operative pain severity, analgesic intake, and complications in children undergoing tonsillectomy and adenoidectomy with bipolar radiofrequency ablation (Coblation) vs. pulsed-electron avalanche knife (PEAK) technology.
  
  
  METHODS
  This was a prospective, non-randomized, non-blinded comparative cohort study in a private practice setting with three fellowship-trained pediatric otolaryngologists. Patients aged 3 to 12years undergoing tonsillectomy and adenoidectomy were assigned to surgery with either bipolar radiofrequency ablation or pulsed electron avalanche knife instrumentation. Daily telephone contact for the first 14 post-operative days obtained the following data: validated proxy pain scale scores, number of post-operative analgesic medication doses consumed, and occurrence and severity of post-operative hemorrhage.
  
  
  RESULTS
  One-hundred adenotonsillectomy subjects were enrolled (50 bipolar radiofrequency ablation, 50 pulsed-electron avalanche knife). There were no clinically relevant differences in post-operative pain scores between the two surgical groups on all post-operative days. Total doses of non-narcotic and narcotic analgesics were similar between the groups, with the exception of less acetaminophen doses being consumed in pulsed-electron avalanche knife patients on post-operative days 9, 10, and 12. Post-operative hemorrhage episodes resulting in re-operation and/or hospitalization were equivalent between the two groups. However, bipolar radiofrequency ablation patients were 2.33 times more likely to experience minor bleeding events at home (that did not require medical intervention).
  
  
  CONCLUSIONS
  Pulsed-electron avalanche knife surgery was found to be an adequate technique for pediatric adenotonsillectomy, with similar amounts of post-operative pain and clinically relevant hemorrhage when compared to bipolar radiofrequency ablation.
authors: Center for Pediatric ENT, 10301 Hagen Ranch Road, Boynton Beach, FL.
authors: Zorik
authors: Z
authors: Spektor
authors: Center for Pediatric ENT, 10301 Hagen Ranch Road, Boynton Beach, FL.
authors: David J
authors: DJ
authors: Kay
authors: Center for Pediatric ENT, 10301 Hagen Ranch Road, Boynton Beach, FL. Electronic address: dmandel4@fau.edu.
authors: David L
authors: DL
authors: Mandell
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects / Q000379:methods*; D000700:Analgesics / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004564:Electrocoagulation; D004598:Electrosurgery; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D012891:Sleep Apnea Syndromes / Q000601:surgery; D014068:Tonsillectomy / Q000009:adverse effects / Q000379:methods*; D014069:Tonsillitis / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics