Post-Tonsillectomy Pain:Is Cold Steel Dissection Method or Bipolar Diathermy Dissection Method is less Painful?

Abstract

Background: Pain is one of the sequel of tonsillectomy, as reported in various studies. Tonsillectomy can be done by various methods, so aim of the present study is to evaluate pain of tonsillectomy comparing cold steel dissection method with bipolar diathermy method.Objective: To evaluate post-tonsillectomy pain comparing cold steel dissection method with bipolar diathermy method.Material and Methods: This prospective, randomized, controlled trial was conducted in ENT Department, from 18th January 2021 to January 30th 2022. Post tonsillectomy pain was measured by using visual analogue scale which consists of a 10 cm line with score of 10 means worse pain and score of zero means no pain. In this study a total sample size was 186 patients (i.e. 93 in each group), who were observed by taking the following parameters. Mean ± SD of group A (bipolar diathermy group) = 2.27 ± 1.25. Mean ± SD of group B (cold steel dissection group) = 1.59 ± 1.59. Confidence interval (2-sided) =95%. Power=90%. More over consecutive (nonprobability) sampling technique was used for sample collection.Results: In bipolar dissection group (38%) patients were male and (62%) patients were female. Where as in cold dissection group (40%) patients were male and (60%) patients were female. The mean pain score at 24 hours, 2ndpost operative day, 7th post operative day among two groups was analyzed. In bipolar dissection group, mean pain score at 24 hours was 3.5 ± 0.66, mean pain score at 2nd post operative day was 2.93 ± 0.73 and mean pain score at 7th post operative was 1.59 ± 1.02. Where as in cold dissection group, mean pain score at 24 hours was 3.33 ± 0.53 with a p value of 0.0543, mean pain score at 2ndpost operative day was 2.34 ± 0.60 with a p value of 0.0001and mean pain score at 7th post operative was 1.46 ± 0.82 with a p value of 0.3394.Conclusion: Our study concludes that mean pain score is less in cold steel dissection tonsillectomy as compared to bipolar diathermy tonsillectomy.Keywords: Analogue pain scale, Surgical Diathermy, Tonsillectomy.