A comparison of intraoperative hemostatic techniques during tonsillectomy: Suture versus electrocautery - A study to assess post operative pain scores and duration to resumption of normal diet.

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A comparison of intraoperative hemostatic techniques during tonsillectomy: Suture versus electrocautery - A study to assess post operative pain scores and duration to resumption of normal diet.

Clin Otolaryngol. 2018 May 07;:

Authors: Cassano M, Bayar Muluk N, Di Taranto F, Subramaniam S

Abstract
OBJECTIVES: To assess postoperative pain and pattern of recovery to normal diet in children who underwent tonsillectomy.
METHODS: Cold steel tonsillectomy (or adenotonsillectomy) was performed in 61 children. Hemostasis was attained with sutures in Group 1 (n=30, 8 tonsillectomy and 22 adenotonsillectomy), and electrocautery in Group 2 (n=31,6 tonsillectomy and 25 adenotonsillectomy). Information obtained included post-operative pain scores and the number of postoperative days taken to resume normal diet. The pain score was evaluated with the Wong-Baker FACES® Pain Rating Scale (WBFS).
RESULTS: Pain values in Group 1 (hemostasis with sutures) were significantly lower than those in Group 2 (hemostasis with cauterization) from the 6th hour to the 7th postoperative day (p<0.05). For both liquid and solid food, Group 1 returned to normal diet earlier, compared to Group 2 (p<0.05). When comparing patients undergoing tonsillectomy versus adenotonsillectomy, resumption of normal diet was achieved later in the adenotonsillectomy patients (p<0.05). In terms of postoperative bleeding, there were 2 significant events in Group 2 (electrocautery group), occurring on the1st (severe) and 10th day (slight) in 2 children (6.5%). There were no postoperative bleeding events in Group 1.
CONCLUSION: Our results showed that suture hemostatis causes less pain and faster resumption of normal diet compared to electrocautery. In view of this, we recommend the use of sutures for achieving intraoperative hemostasis in pediatric patients. This article is protected by copyright. All rights reserved.

PMID: 29733506 [PubMed - as supplied by publisher]

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