MONOPOLAR CAUTERY VERSUS COLD STEEL DISSECTION FOR TONSILLECTOMY IN CHILDREN. A RANDOMIZED CLINICAL TRIAL

Monopolar Cautery Versus Cold Steel Dissection

Abstract

Objective: To compare monopolar cautery with cold steel dissection for tonsillectomy in pediatric age  group.
Study Design: A randomized clinical trial.
Place and Duration of Study: Ear, nose and throat (ENT) department Combined Military Hospital Gujranwala,from Jan 2013 to Jan 2015.
Material and Methods: A total of 220 consecutive pediatric patients undergoing tonsillectomy for recurrent or chronic tonsillitis between Jan 2013 to Jan 2015. Both groups were compared with regards to surgery time, intraoperative bleeding, post operative pain and complications.
Results: A total of 20 patients were excluded from the study for various reasons while the data of the rest of the patients has been presented. Mean age of the study group was 8.82 years. A total of 58% of the patients were male. Average time of surgery for monopolar cautery was 29.33 (SD 2.77) min as compared to 18.53 min (SD 2.94) for dissection method which was significant (p<0.005). Average blood loss for monopolar surgery was 11.66 ml and 29.04ml for dissection method (p<0.005). Average pain scores were less for dissection method at 2nd post op day 3.59 vs. 5.51. Rates of primary and secondary hemorrhage were less for monopolar method although they were not statistically significant.
Conclusion: Monopolar cautery though causes decreased intraoperative blood loss however requires longer
anesthesia and causes significant post operative pain to the patient.