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
[11]   Postoperative tonsillectomy pain in pediatric patients - Electrocautery (hot) vs cold dissection and snare tonsillectomy - A randomized trial [J].
Nunez, DA ;
Provan, J ;
Crawford, M .
ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY, 2000, 126 (07) :837-841
[12]   Tonsillectomy using an ultrasonically activated scalpel [J].
Ochi, K ;
Ohashi, T ;
Sugiura, N ;
Komatsuzaki, Y ;
Okamoto, A .
LARYNGOSCOPE, 2000, 110 (07) :1237-1238
[13]   Comparison of postoperative emesis, recovery profile, and analgesia in pediatric strabismus repair - Rectal acetaminophen versus intravenous fentanyl-droperidol [J].
Padda, GS ;
Cruz, OA ;
Krock, JL .
OPHTHALMOLOGY, 1997, 104 (03) :419-424
[14]   The effect of preoperative dexamethasone on the immediate and delayed postoperative morbidity in children undergoing adenotonsillectomy [J].
Pappas, ALS ;
Sukhani, R ;
Hotaling, AJ ;
Mikat-Stevens, M ;
Javorski, JJ ;
Donzelli, J ;
Shenoy, K .
ANESTHESIA AND ANALGESIA, 1998, 87 (01) :57-61
[15]   A comparison of microbipolar cautery dissection to hot knife and cold knife cautery tonsillectomy [J].
Pizzuto, MP ;
Brodsky, L ;
Duffy, L ;
Gendler, J ;
Nauenberg, E .
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, 2000, 52 (03) :239-246
[16]  
Sood S, 2001, Ear Nose Throat J, V80, P514
[17]  
Sutters K A, 1997, J Pediatr Nurs, V12, P178, DOI 10.1016/S0882-5963(97)80075-9
[18]   Harmonic scalpel tonsillectomy versus electrocautery tonsillectomy: A comparative pilot study [J].
Walker, RA ;
Syed, ZA .
OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2001, 125 (05) :449-455
[19]   Pain progression, intensity and outcomes following tonsillectomy [J].
Warnock, FF ;
Lander, J .
PAIN, 1998, 75 (01) :37-45
[20]   Recovery after tonsillectomy: Electrodissection vs sharp dissection techniques [J].
Wexler, DB .
OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 1996, 114 (04) :576-581