Study Finds Surgical Technique May Reduce Pain After Tonsillectomy

Seattle, Wash.: Researchers from Children's Hospital and Regional Medical Center and the Albany Medical Center have found that using a surgical technique involving the microdissection needle during surgical removal of the tonsils may reduce the amount of pain experienced after tonsillectomy.


Seattle, Wash.: Researchers from Children's Hospital and Regional Medical Center and the Albany Medical Center have found that using a surgical technique involving the microdissection needle during surgical removal of the tonsils may reduce the amount of pain experienced after tonsillectomy.

The study results were published in an article in the December issue of The Archives of Otolaryngology, one of the JAMA/Archives journals.

Jonathan Perkins, D.O., Children's Hospital and Regional Medical Center, and Ravinder Dahiya, M.D., Albany Medical Center, Albany, N.Y., investigated whether microdissection needle cautery (which is a type of electrocautery which uses less energy, and may therefore be less traumatic to tissues) reduced pain after surgery compared to standard electrocautery (which controls bleeding by heating tissues).

Pain after tonsillectomy is of special concern because it can interfere with eating and drinking, and researchers have observed an increase in pain associated with electrocautery.

The researchers randomized 42 children to undergo tonsillectomy into two groups: in group A, tonsillectomy was performed using standard electrocautery; in group B, tonsillectomy was performed using a lower-energy microdissection needle. The same surgeon performed all surgeries, which were identical except for the use of the instrument. Patients were asked to rate their post-operative pain using a questionnaire based on a 10 point pain scale (10 being the worst pain). Doses of pain medication taken were also noted.

The researchers found that there was no difference in hemorrhage (bleeding) during the operations between the two groups. The operation took an average of 3.2 minutes longer for group B. However, postoperative pain was less on days three, four and five following surgery for patients in the microdissection group than for patients in the standard electrocautery group.

"Without any increase in complications, subjective and objective measurement showed that the use of the microdissection needle resulted in significantly less postoperative pain by day three," the authors write.

View the paper abstract.

(Arch Otolaryngol Head Neck Surg. 2003;129:1285-1288. Available post-embargo at archoto.com)

Editor's Note: The microdissection needle tips used in this study were provided by Colorado Biomedical Corporation, Evergreen, Colo.

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