Impact of cold dissection tonsillectomy method combined with selective low voltage bipolar diathermy cauterization on the post tonsillectomy pain in the pediatric age group
Keywords:Tonsillectomy, Cold dissection, Bipolar diathermy, Post tonsillectomy pain
Background: Pediatric tonsillectomies are commonly performed by cold dissection or electro cautery dissection. Both the techniques have been compared in many articles for their role in controlling the post-operative pain and bleeding. With the electro cautery dissection the blood loss is comparatively less, but the post-operative pain is reported as more. Several expensive new techniques are available to address the problems. A simple technique of cold dissection tonsillectomy combined with selective low voltage bipolar diathermy cauterization performed in the pediatric age group is being studied retrospectively for its impact in managing the post-operative pain.
Methods: The case records of 73 patients aged 4-15 years who were operated for tonsillectomy from January 2018 to July 2019 are retrospectively studied. 33 patients underwent cold dissection and ligature tonsillectomy and 40 patients underwent tonsillectomy by cold dissection combined with selective low voltage bipolar diathermy cauterization. The postoperative pain incidence in these two groups is studied.
Results: The cold dissection tonsillectomy combined with selective low voltage bipolar diathermy cauterization technique was found to be useful in managing the postoperative pain in pediatric tonsillectomies.
Conclusions: Performing cold dissection tonsillectomy with precise mucosal incision, gentle dissection and combining it with selective low voltage bipolar diathermy cauterization of the bleeding points was found to be helpful in controlling the postoperative pain in pediatric tonsillectomies. Prescribing a syrup form of NSAID from the second post-operative day was found to be of additional help.
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