Subtotal bipolar tonsillectomy does not decrease postoperative pain compared to total monopolar tonsillectomy

Abstract

Objective: To determine whether a subtotal bovie tonsillectomy decreases postoperative pain following adenotonsillectomy.

Methods: A prospective, randomized, double-blinded clinical trial was undertaken at a University Pediatric Children's Hospital and included 39 otherwise healthy children, aged 2-12 years, undergoing adenotonsillectomy. Patients were randomized to receive either a subtotal or total removal of the tonsils utilizing an electrocautery technique. The main outcome measures included a visual analog scale (VAS) at rest and while eating, time to take 100 cm(3) of fluid, throat, neck, and ear pain, quantity of liquids, activity level and incidence of emesis and retching.

Results: A repeated measures analysis using a repeated measures ANOVA failed to demonstrate a statistically significant impact with either treatment for VAS at rest or while eating (p=0.52 and 0.48, respectively). A repeated measures analysis did not show either procedure significantly affecting throat, neck or ear pain, or liquid quantity. Time to take 100 cm(3) liquids and the incidence of emesis or retching were found not to be statistically significantly different between the treatment groups.

Conclusion: Subtotal tonsillectomy via an electrocautery technique does not reduce postoperative pain or improve outcome parameters. Subtotal tonsillectomy with this technique is not recommended for this patient population.