Bipolar Diathermy versus Conventional Cold Dissection Method A Comparison of Mean Operative Blood Loss

Background: Intra-operative hemorrhage is the most significant complication in tonsillectomy. No previous study has been doneto assess the efficacy of bipolar diathermy regarding intra-operative blood loss during tonsillectomy in local population so far. Aim: To compare the mean intra-operative blood loss during tonsillectomy using bipolar diathermy versus cold dissection method. Methodology: A Randomized Controlled Trial was carried out in the ENT Department, The Children's Hospital, Lahore within six months (1st February 2017-31st July 2017) on 100 patients divided in 2 equal groups i.e. patients to be operated with bipolar diathermy (group B) and operation with cold dissection procedure (group C). After taking consent from patient they were operated as the first case in operation list. Anesthetist was not aware of the type of procedure opted for a specific patient. After anesthetizing the patient, same type of surgery (tonsillectomy with bipolar diathermy & cold dissection) was performed on both group patients by same surgeon under same operative environment. Post-operatively patients were kept in recovery and then shifted to the ward. Operative blood loss was measured by direct method. Results: Male predominancy was observed in the current study (male-female ratio in group B:1.5:1 and in group C:1.6:1) The Mean +/- SD of the ages were 10.78 +/- 3.25 years and 11.14 +/- 3.68 years respectively. The mean operative blood loss presents statistically significant difference between two groups B & C (P<0.05). Conclusion: Bipolar diathermy is an effective and safe technique in pediatric patients. Advantages were observed in terms of shorter operative time and minimal intra-operative blood loss.