‘Hemostatic pause’ in pediatric tonsillectomy?

Abstract

A randomized prospective study was performed on 101 children undergoing dissection tonsillectomy in two different sequences. In the ‘pause’ sequence, a period of inactivity lasting 1.5 min (‘hemostatic pause’) with the Boyle-Davis gag relaxed and the fossae packed with gauze swabs was implemented after the tonsils were excised. Hemorrhage was controlled exclusively by ligatures. The duration of tonsillectomy and the number of ligatures used were accurately recorded. The procedure was identical in the ‘no pause’ group but the pause period was omitted. No reactionary haemorrhage occurred. There was no significant difference in the operating time between the two groups, but the mean number of ligatures required was significantly reduced in the ‘pause’ sequence. We conclude that ‘hemostatic pause’ in tonsillectomy reduces the amount of ligatures needed for satisfactory hemostasis.