A comparison of tonsillectomy with the harmonic scalpel versus electrocautery

被引:21
作者
Morgenstein, SA [1 ]
Jacobs, HK [1 ]
Brusca, PA [1 ]
Consiglio, AR [1 ]
Donzelli, J [1 ]
Jakubiec, JA [1 ]
Donat, TL [1 ]
机构
[1] Cent DuPage Hosp, Winfield, IL 60190 USA
关键词
D O I
10.1067/mhn.2002.128346
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
OBJECTIVE. We sought to test whether the use of the harmonic scalpel would cause less pain and more rapid recovery in tonsillectomy patients versus the use of electrocautery. DESIGN AND SETTING: In a private practice community hospital, we conducted a prospective nonrandomized comparison of 156 pediatric tonsillectomy cases. Local anesthetic infiltrations and steroids were used at the discretion of the surgeon. Outcome variables consisted primarily of immediate-and mid-term pain, pain medications required, time to eating, morbidities and charges. RESULTS., There were no differences between the groups on an intention-to-treat basis except for costs, which were higher in the harmonic scalpel group. When rescue use of electrocautery was required to control bleeding in the in the harmonic scalpel patients, more pain and longer times to taking food were noted. CONCLUSIONS., Used with discretion the harmonic scalpel is equivalent to electrocautery for tonsillectomy. SIGNIFICANCE. The harmonic scalpel does not provide a major benefit over more conventional methods of tonsillectomy.
引用
收藏
页码:333 / 338
页数:6
相关论文
共 20 条
[1]   Harmonic Scalpel® vs. electrocautery hemorrhoidectomy:: A prospective evaluation [J].
Armstrong, DN ;
Ambroze, WL ;
Schertzer, ME ;
Orangio, GR .
DISEASES OF THE COLON & RECTUM, 2001, 44 (04) :558-564
[2]   A prospective study on pros and cons of electrodissection tonsillectomy [J].
Blomgren, K ;
Qvarnberg, YH ;
Valtonen, HJ .
LARYNGOSCOPE, 2001, 111 (03) :478-482
[3]   Single-dose dextropropoxyphene in post-operative pain: a quantitative systematic review [J].
Collins, SL ;
Edwards, JE ;
Moore, RA ;
McQuay, HJ .
EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY, 1998, 54 (02) :107-112
[4]  
Costas-Gastiaburo LA, 1998, S AFR J SURG, V36, P142
[5]   PHARMACOKINETICS AND CLINICAL EFFICACY OF INTRARECTAL SOLUTION OF ACETAMINOPHEN [J].
GAUDREAULT, P ;
GUAY, J ;
NICOL, O ;
DUPUIS, C .
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 1988, 35 (02) :149-152
[6]  
HOLLIS LJ, 2000, COCHRANE DATABASE SY, V2
[7]   Tonsillectomy by guillotine is less painful than by dissection [J].
Homer, JJ ;
Williams, BT ;
Semple, P ;
Swanepoel, A ;
Knight, LC .
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, 2000, 52 (01) :25-29
[8]   Complications of paediatric tonsillectomy post-discharge [J].
Lee, WC ;
Sharp, JF .
JOURNAL OF LARYNGOLOGY AND OTOLOGY, 1996, 110 (02) :136-140
[9]  
McCaffery M, 1999, PAIN CLIN MANUAL, P241
[10]  
Metternich FU, 2001, HNO, V49, P465, DOI 10.1007/s001060170098