Effect of modified bipolar tonsillectomy on postoperative pain

Abstract

Background: Tonsillectomy is commonly performed otolaryngological operation. It can cause considerable pain in children. Different types of tonsillectomy are described in the literature. Modified technique of bipolar tonsillectomy can significantly reduce postoperative pain. Objective: This study aimed to assess postoperative pain in children after modified bipolar tonsillectomy. Methods: 120 patients, age 6-12 years, were selected for this study. Indication for tonsillectomy was a history of recurrent tonsillitis. Spetzler-Malis bipolar forceps (tip size 0.5 mm) with low energy (5 W) was applied. We tried to preserve the pillars as much as possible. Pain was assessed on 1st, 3rd, 5th, 7th and 10th postoperative days. The pain was evaluated with visual analogue scale (VAS). Results: On the first day of the operation 114 patients (95%) had no pain, 6 patients (5%) had mild pain, on the third postoperative day in 95% pain was mild, in 5% pain was moderate, on the fifth postoperative day pain was mild in 84 patients (70%), 36 patients (30%) had moderate pain, on the seventh postoperative day 95% of patients did not present pain, 5% of patients had mild pain. On the tenth postoperative day no one had pain. None of them presented nausea, vomiting, otalgia or severe pain. Conclusion: Low energy electrocautery, direct cautery to the tonsillar bed and preservation of the mucosa are all effective measures that have diminished post-op pain in bipolar dissection. *Correspondence to: Gevorg Saghatelyan, Arabkir Medical Centre, Department of Otorhinolaryngology, Yerevan, Armenia, Tel: +37498118619, E-mail: ruslangevorg@gmail.com