Reducing Postoperative Pain from Tonsillectomy Using Monopolar Electrocautery by Cooling the Oropharynx
16 September 2013
27 October 2013
06 January 2014 (online)
Objective Evaluate intraoperative cooling of the oropharynx to reduce postoperative pain in tonsillectomy using monopolar electrocautery.
Methods Sixty-six patients, age 1 to 12 years, were selected for the study, 33 in the control group and 33 in the experimental group. After randomization, patients underwent subcapsular dissection and hemostasis with monopolar electrocautery. Patients in the experimental group had the oropharynx cooled after tonsil dissection and hemostasis for 10 minutes. The procedure was done through the oral cavity by irrigation with 500 mL of 0.9% saline, in temperatures between 5°C and 10°C, for 5 minutes. The evaluation of postoperative pain was made with the pain visual analog scale (VAS) for 10 days. As complementary data on the evaluation of pain, we recorded daily use of ketoprofen for pain relief.
Results Pain after tonsillectomy assessed by VAS was significantly lower in the experimental group at days 0, 5, and 6 (p < 0.05). There were no differences in the use of ketoprofen between the groups.
Conclusion Cooling of the oropharynx after tonsillectomy promotes clinically significant reduction in postoperative pain, without additional complications.
- 1 Cornejo SS, Beltrán MC, Breinbauer KH, Fonseca AX, Serra TR. Dolor em amigdalectomía: Técnica fría versus electrobisturí monopolar. Estudio prospectivo randomizado. Revista de otorrinolaringología y cirugía de cabeza y cuello 2010; 70 (2) 123-128
- 2 Horii A, Hirose M, Mochizuki R , et al. Effects of cooling the pharyngeal mucosa after bipolar scissors tonsillectomy on postoperative pain. Acta Otolaryngol 2011; 131 (7) 764-768
- 3 Robinson SR, Purdie GL. Reducing post-tonsillectomy pain with cryoanalgesia: a randomized controlled trial. Laryngoscope 2000; 110 (7) 1128-1131
- 4 Wiikmann V, Prado FAP, Caniello M, Di Francesco RC, Miziara ID. Complicações pós-operatórias em tonsilectomias. Braz J Otorhinolaryngol 2004; 70 (4) 464-468
- 5 Vaz JLM, Vaz MC. Fisiopatologia da Dor Pós-Operatória. 1st ed. Rio de Janeiro, Brazil: Colégio Brasileiro de Cirurgiões; 2005
- 6 Sylvester DC, Rafferty A, Bew S, Knight LC. The use of ice-lollies for pain relief post-paediatric tonsillectomy. A single-blinded, randomised, controlled trial. Clin Otolaryngol 2011; 36 (6) 566-570
- 7 Muñoz-Blanco F, Salmerón J. Complicaciones del dolor postoperatorio. Rev Soc Esp Dolor 2001; 8 (3) 194-211