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Cold Dissection Versus Coblation‐Assisted Adenotonsillectomy in Children
Author(s) -
Shapiro Nina L.,
Bhattacharyya Neil
Publication year - 2007
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/mlg.0b013e31802ffe47
Subject(s) - medicine , tonsillectomy , adenoidectomy , randomized controlled trial , anesthesia , surgery , dissection (medical) , blood loss , pain score , prospective cohort study , postoperative pain
Objective: To compare intraoperative efficiency and postoperative recovery between cold dissection adenotonsillectomy (CDA) and coblation‐assisted adenotonsillectomy (CAA). Methods: A prospective, randomized, single‐blind trial of pediatric patients aged 2 to 16 years undergoing adenotonsillectomy was conducted. Patients were randomized to undergo either CDA or CAA. Measured intraoperative parameters included surgical duration and intraoperative blood loss. Measured postoperative parameters included a 14 day caregiver questionnaire that recorded a daily pain rating using the Wong‐Baker FACES pain scale, pain medication use, days to return to a normal diet, and days to return to a normal caregiver routine. Postoperative complications were also recorded. Intraoperative and postoperative measures were statistically compared between groups. Results: Forty‐six children with a mean age of 6.7 years (23 CDA and 23 CAA) were randomized and completed the study. Mean age and sex distributions were similar between groups ( P > .05). Surgical times were significantly shorter for the CAA group versus the CDA group (11.2 min vs. 17.0 min, P < .001). Intraoperative blood loss was statistically lower for both the adenoidectomy and tonsillectomy portions of the procedure for the CAA group versus the CDA group ( P < .001 and P < .001, respectively). There was no statistically significant difference in reported daily pain scores between groups ( P = .296, analysis of variance). Both groups returned to normal diet ( P = .982), and caregivers returned to their normal routine on similar postoperative days ( P = .631). Conclusions: CAA offers better operative speed and intraoperative hemostasis as compared with CDA. However, CAA does not result in poorer postoperative pain scores or recoveries despite these intraoperative advantages.