Effects of cooling the pharyngeal mucosa after bipolar scissors tonsillectomy on postoperative pain

Abstract

Conclusion: Bipolar scissors tonsillectomy followed by cooling down the pharyngeal mucosa has advantages in terms of postoperative pain and intraoperative blood loss compared with cold dissection. Objectives: The purpose of this study was to compare the postoperative pain between bipolar scissors tonsillectomy followed by cooling the pharyngeal mucosa and a traditional cold dissection. Methods: A total of 189 patients aged more than 16 years were operated due to habitual tonsillitis, obstructive sleep apnea syndrome, and IgA nephropathy. Of these, 79 patients were operated using bipolar scissors followed by cooling the pharyngeal mucosa with 4°C saline for 10 min just after the removal of tonsils. The other 110 patients underwent cold dissection tonsillectomy. Outcome measures were intraoperative blood loss, operative time, postoperative pain evaluated on a visual analog scale, and postoperative secondary hemorrhage. Results: Significantly lower levels of intraoperative blood loss and less postoperative pain were obtained in bipolar scissors tonsillectomy followed by cooling the pharyngeal mucosa compared with cold dissection. Postoperative hemorrhage needing hemostatic surgery occurred in 2 of 79 patients who underwent bipolar scissors tonsillectomy with cooling, while it occurred in 1 of 110 patients after cold dissection. However, the difference was not statistically significant.

Keywords::

• Visual analog scale
• blood loss

Acknowledgments

The authors thank Dr K. Mori and Y. Fuse at Osaka Seamen's Insurance Hospital and Dr M. Yamashita at Toyonaka Municipal Hospital for providing data on cold dissection. Results of this study were presented at the 7th International Symposium on Tonsils and Mucosal Barriers of the Upper Airways (ISTMB) at Asahikawa.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.