Evaluating postoperative pain in monopolar cautery versus harmonic scalpel tonsillectomy.

OBJECTIVES

To compare postoperative pain between monopolar cautery tonsillectomy and harmonic scalpel tonsillectomy (HST).

STUDY DESIGN

Randomized controlled trial using paired organs.

SETTING

Community hospital with academic affiliation.

SUBJECTS

One hundred and fourteen consecutive patients six years of age or older undergoing tonsillectomy for indications of hypertrophy or recurrent infection.

METHODS

For each subject, monopolar cautery tonsillectomy was performed by four senior surgeons on one side and HST was performed on the other side. Allocation of technique to side was randomized and revealed to the surgeon at the start of the operation. Validated visual analog pain scales were used to quantify pain at rest and with swallowing for each side and were completed daily for 14 days. All subjects were prescribed weight-equivalent doses of analgesics. Secondary outcome measures included postoperative complications (hemorrhage and readmission).

RESULTS

Pairwise comparisons of pain scores revealed no significant difference between monopolar cautery tonsillectomy and HST (P < 0.05).

CONCLUSIONS

Subjects undergoing monopolar cautery tonsillectomy do not experience increased postoperative pain in comparison to HST.