Harmonic scalpel versus conventional tonsillectomy: a double-blind clinical trial

Patrick J Collison; Robin Weiner

doi:10.1177/014556130408301017

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Harmonic scalpel versus conventional tonsillectomy: a double-blind clinical trial

Journal article

Open access

Peer reviewed

Harmonic scalpel versus conventional tonsillectomy: a double-blind clinical trial

Patrick J Collison and Robin Weiner

Ear, nose, & throat journal, Vol.83(10), pp.707-710

10/2004

DOI: 10.1177/014556130408301017

PMID: 15586874

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https://doi.org/10.1177/014556130408301017View

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Abstract

We conducted a prospective, double-blind clinical trial to evaluate the differences in operating time, intraoperative blood loss, postoperative pain at 3 hours and 1 week, and delayed (>24 hr) bleeding associated with ultrasonic harmonic scalpel tonsillectomy and conventional tonsillectomy. The study was carried out on 28 patients with recurrent tonsillitis and/or adenotonsillar hypertrophy who underwent harmonic scalpel tonsillectomy on one side and cold dissection tonsillectomy with suction electrocautery hemostasis on the other. The harmonic scalpel was associated with significantly less intraoperative blood loss (mean: 6.2 vs. 58.8 ml; p < 0.0001) and less early (3 hr) postoperative pain as determined by scores on a 10-point visual analog scale (mean: 3.5 vs. 4.4; p = 0.0042); although the difference in early pain scores is statistically significant, it is probably not clinically significant. Pain scores at 1 week were nearly identical (mean: 2.7 vs. 2.6; p = 0.9246). The length of operating time was similar (mean: 10.9 vs. 7.7 min; p = 0.0022). An unanticipated finding was the fact that delayed bleeding, which occurred in 3 patients (10.7%), occurred only on the harmonic scalpel side. We conclude that the only clearly demonstrable advantage that the harmonic scalpel had over cold dissection was that it caused less intraoperative blood loss.

Adolescent

Adult

Blood Loss, Surgical

Child

Double-Blind Method

Electrocoagulation - instrumentation

Female

Humans

Hypertrophy

Male

Pain Measurement

Palatine Tonsil - pathology

Recurrence

Tonsillectomy - instrumentation

Tonsillectomy - methods

Tonsillitis - surgery

Details

Title: Subtitle: Harmonic scalpel versus conventional tonsillectomy: a double-blind clinical trial
Creators: Patrick J Collison - Yankton Rural Area Health Education Center
Robin Weiner - Yankton Rural Area Health Education Center
Resource Type: Journal article
Publication Details: Ear, nose, & throat journal, Vol.83(10), pp.707-710
DOI: 10.1177/014556130408301017
PMID: 15586874
ISSN: 0145-5613
eISSN: 1942-7522
Language: English
Date published: 10/2004
Academic Unit: Otolaryngology
Record Identifier: 9984697738402771

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