Coblation tonsillectomy versus coblation tonsillectomy with ties in adults

Objective This study was performed to compare the intraoperative and postoperative courses of coblation tonsillectomy and coblation tonsillectomy with ties in adults. Methods All patients who underwent tonsillectomy from July 2012 to September 2016 were retrospectively reviewed. Intraoperative and postoperative bleeding, pain, and return to normal food intake were compared between patients who underwent coblation tonsillectomy and those who underwent coblation tonsillectomy with ties. Results Of 515 patients, 300 (58.3%) underwent coblation tonsillectomy and 215 (41.7%) underwent coblation tonsillectomy with ties. Twenty-five (4.9%) patients developed postoperative hemorrhage, 22 (88.0%) of whom had undergone coblation tonsillectomy and 3 (12.0%) of whom had undergone coblation tonsillectomy with ties. Patients who underwent coblation tonsillectomy reported less pain than those who underwent coblation tonsillectomy with ties. Patients who underwent coblation tonsillectomy with ties resumed a normal diet significantly later than those who underwent coblation tonsillectomy (10.0 ± 3.2 vs. 8.2 ± 1.9 days, respectively). Conclusion Coblation tonsillectomy is associated with less intraoperative bleeding, a shorter surgery time, less postoperative pain, and fewer days to recovery of a normal diet than is coblation tonsillectomy with ties. However, coblation tonsillectomy with ties is associated with remarkably reduced postoperative hemorrhage.

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Intraoperative Cryoanalgesia for Reducing Post-Tonsillectomy Pain: A Systemic Review

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489418772859 ◽

2018 ◽

Vol 127 (6) ◽

pp. 395-401 ◽

Cited By ~ 2

Author(s):

Blake S. Raggio ◽

Blair M. Barton ◽

Maria C. Grant ◽

Edward D. McCoul

Keyword(s):

Postoperative Pain ◽

Randomized Controlled Trials ◽

English Language ◽

Postoperative Bleeding ◽

Age Groups ◽

Normal Diet ◽

Systemic Review ◽

Controlled Trials ◽

Randomized Controlled ◽

Significant Difference

Objective: Summarize the effectiveness of intraoperative cryoanalgesia in the management of postoperative pain among patients undergoing palatine tonsillectomy. Methods: A systematic review of PubMED, MEDLINE, EMBASE, Google Scholar, and Cochrane trial registries was performed through January 2017 using the PRISMA standards. We included English-language randomized controlled trials evaluating patients of all age groups with benign pathology who underwent tonsillectomy with cryoanalgesia versus without. Results: Three limited quality randomized controlled trials involving 153 participants (age range, 1-60 years) were included. Cryoanalgesia was performed with a cryotherapy probe (−56°C) in 1 trial and ice-water cooling (4°C to 10°C) in 2. In the 3 trials reviewed, patients who received cryoanalgesia reported 21.38%, 28.33%, and 31.53% less average relative postoperative pain than controls on the visual analog scale. Review of secondary outcomes suggested no significant difference in time to resume normal diet (2 studies) or postoperative bleeding (2 studies) between the 2 groups. Cryoanalgesia allowed patients to return to work 4 days earlier than controls in 1 study. Two studies reported a trend toward less postoperative analgesia use among the treatment group; however, no statistical conclusions could be drawn. Conclusion: The available evidence suggests that patients undergoing tonsillectomy with cryoanalgesia experience less average postoperative pain without additional complications.

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Coblation vs. dissection tonsillectomy: a prospective randomized study comparing surgical and clinical outcomes

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20190492 ◽

2019 ◽

Vol 5 (2) ◽

pp. 306

Author(s):

Shifa Vyas ◽

Pritosh Sharma ◽

Nitin Sharma ◽

Abhijit Makwana ◽

V. P. Goyal

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Randomized Study ◽

Postoperative Bleeding ◽

Intraoperative Blood Loss ◽

Surgical Time ◽

Intraoperative Bleeding ◽

Time Required ◽

Pain Patients ◽

Better Than

Background: The objective of this study is to compare operative time, intraoperative bleeding, postoperative pain between coblation and dissection tonsillectomy.Methods: A total of 62 patients who met the inclusion criteria were divided into two groups according to the surgical procedure they went through. Surgical time intraoperative blood loss, postoperative pain, postoperative regaining of activity and any episode of postoperative bleeding were noted in both the groups and compared. Results: Coblation tonsillectomy fared better than dissection tonsillectomy in terms of having less intraoperative blood loss, less postoperative pain. Patients who underwent coblation assisted tonsillectomy also had earlier return to normal activities. Though the time required for coblation tonsillectomy was more than dissection tonsillectomy there were no episodes of postoperative bleeding in subjects who underwent coblation tonsillectomy.Conclusions: Coblation assisted tonsillectomy is a promising new technique for tonsillectomy as patients had less postoperative morbidity mainly pain. The surgical time required could be reduced further with experience.

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A Comparative Study of Coblation versus Dissection Tonsillectomy

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v26i2.50613 ◽

2020 ◽

Vol 26 (2) ◽

pp. 121-127

Author(s):

Dipankar Lodh ◽

SM Abdul Awual ◽

Md Tawhidul Islam Mondol ◽

Md Shahriar Islam ◽

Mohammad Nazrul Islam ◽

...

Keyword(s):

Postoperative Pain ◽

Recovery Time ◽

Postoperative Morbidity ◽

Normal Diet ◽

Chronic Tonsillitis ◽

Study Patient ◽

Intraoperative Bleeding ◽

Duration Of Surgery ◽

Time Required ◽

Cold Dissection

Objectives: To compare the efficacy of coblation tonsillectomy and dissection tonsillectomy regarding the duration of surgery, amount of intraoperative bleeding, postoperative pain, recovery time and complications. Methods: 50 patients aged 5-30 years with chronic tonsillitis who underwent tonsillectomy operation were randomly divided into two groups. One group underwent coblation tonsillectomy while other group with dissection tonsillectomy. Chronic tonsillitis patients with adenoid hypertrophy and Otitis media with effusion were excluded by diagnostic nasal endoscopy, imaging and audiometry. All patient were examined regularly after surgery for 10 days to assess the postoperative morbidity and efficacy of both coblation and dissection methods. Duration of surgery, amount of intraoperative bleeding, recovery time, postoperative pain& requirement of analgesics, time required to regain normal diet & activityand complication were assessed. Result: Comparing the coblation tonsillectomy to cold dissection group the mean duration of surgery was 9.7 versus 18.4 minutes, the amount of intra operative bleeding 10.62 versus 28.72 milliliter. The difference on the postoperative pain scale, requirement of analgesics, condition of the tonsillar fossa, time required to regain normal diet & activity between two groups were statistically significant. Conclusion: In our study patient underwent coblation tonsillectomy providing a near bloodless field, minimum operating time, less postoperative pain, quicker return to normal diet, normal activity and less use of analgesics than patients underwent dissection tonsillectomy. Postoperative morbidity and complications were lower as compared to conventional cold dissection technique. Bangladesh J Otorhinolaryngol; October 2020; 26(2): 121-127

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Efficacy of Cold-Steel Uvulopalatoplasty

Otolaryngology ◽

10.1177/019459989611500520 ◽

1996 ◽

Vol 115 (5) ◽

pp. 471-473 ◽

Cited By ~ 1

Author(s):

Roy R. Casiano ◽

Shishir Sheth

Keyword(s):

Postoperative Pain ◽

Complete Resolution ◽

Marked Improvement ◽

Average Length ◽

Postoperative Bleeding ◽

Normal Diet ◽

Slight Improvement ◽

Viable Option ◽

Tissue Removal

Sevan patients underwent cold-steel uvulopalatoplasty with tissue removal similar to that being performed with laser-assisted uvulopalatoplasty. The severity and length of postoperative pain, days out of work, postoperative complications, and efficacy in reducing snoring were assessed. The minimum follow-up period was 6 months. The average length of postoperative pain (inability to eat a completely normal diet) was 6 days. All but one patient underwent only one session of cold-steel uvulopalatoplasty with satisfactory relief of snoring. The remaining patient required two sessions. One patient had some mild postoperative bleeding which resolved with silver nitrate. Improvement in snoring goes as follows: marked improvement in three patients, moderate improvement in three patients, and slight improvement in one patient. None of the patients had complete resolution or the same degree of snoring. Patients who underwent concomitant oropharyngeal procedures (i.e., tonsillectomy) in addition to cold-steel uvulopalatoplasty tended to have pain for a longer period of time and required a longer convalescence period. Cold-steel uvulopalatoplasty is an inexpensive and viable option to outpatient laser-assisted uvulopalatoplasty for the reduction of snoring in select patients.

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Studies on the excretion of copper in the rabbit

The Journal of Agricultural Science ◽

10.1017/s0021859600048486 ◽

1941 ◽

Vol 31 (1) ◽

pp. 145-160 ◽

Cited By ~ 4

Author(s):

A. Eden

Keyword(s):

Food Intake ◽

Experimental Animal ◽

Dry Matter ◽

Normal Diet ◽

Urinary Output ◽

Urinary Elimination ◽

Long Period ◽

Total Food ◽

Normal Food ◽

Faecal Elimination

1. In metabolism experiments undertaken to study the channels of elimination of copper under varying conditions, the rabbit was chosen as experimental animal for convenience of manipulation. This choice, although not defeating the main objects of the work, accidentally added valuable informationon the little-known habit of “physiological faecal refection”in this animal.2. On a normal diet of bran and oats, containing the usual traces of copper, the rabbit is in copper equilibrium, excreting as much in faeces and urine as is taken in the food. Urinary elimination is of the order of 0·07–0·38 mg. per litre, but this is very subsidiary to faecal elimination of about 2·5 mg. per 100 g. of dry matter, which may account for even more than 96 % of the total food copper.3. Increase of food copper is not reflected by material increase of urinary output, the higher quantities appearing almost entirely in the faeces. Of 50 mg. of copper or nearly 200 times the normal food intake, as the dissolved sulphate dried on to the food, only 0·1 mg. appeared in the urine, the remainder being slowly excreted in the faeces over the unexpectedly long period of 4 or 5 weeks.

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Plasma Ablation vs Other Hot Techniques for Tonsillectomy: A Meta-analysis

Otolaryngology ◽

10.1177/0194599820923625 ◽

2020 ◽

Vol 163 (5) ◽

pp. 860-869

Author(s):

Guo Liu ◽

Ciyun Xiao ◽

Xu Zhou ◽

Feng Liu

Keyword(s):

Postoperative Pain ◽

Meta Analysis ◽

Postoperative Bleeding ◽

Normal Diet ◽

Current Evidence ◽

Assessment Development ◽

Plasma Ablation ◽

Evidence Quality ◽

The Difference

Objective To evaluate whether plasma ablation tonsillectomy is superior to other hot techniques in reducing postoperative morbidity. Data Sources The databases of PubMed, EMBASE, and Web of Science were used to search the literature, from inception to January 2, 2020. Randomized controlled trials (RCTs) that compared plasma ablation tonsillectomy with any other hot techniques were eligible. Review Methods A modified Cochrane tool was used to assess the risk of bias. The standardized mean difference (SMD) and 95% confidence interval (CI) were used to estimate pooled effects of postoperative pain, and the risk ratio (RR) was used for postoperative bleeding. Subgroup analysis was prespecified to explore the source of heterogeneity. The evidence quality of each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results A total of 15 RCTs were included (n = 1293). Comparing with other hot techniques, plasma ablation tonsillectomy may cause less pain on postoperative day 7 (SMD, −0.53; 95% CI, −0.84 to −0.23). However, the magnitude of the difference may be clinically meaningless. There were no significant differences not only in terms of postoperative pain on day 1 and day 3 but also in the incidence of postoperative bleeding, reoperation hemostasis, and return to normal diet and activities between the 2 groups. Conclusion There is still substantial uncertainty on postoperative pain, bleeding, and recovery. The current evidence is insufficient to demonstrate that plasma ablation is superior to other hot techniques for tonsillectomy.

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Comparison Of Harmonic Scalpel, Coblation And Cold Dissection For Tonsillectomy In Adult

10.22541/au.163252266.66248446/v1 ◽

2021 ◽

Author(s):

Xinqi Hu ◽

Jiaying Li ◽

Xidong Cui ◽

Guangbin Sun

Keyword(s):

Postoperative Pain ◽

Operative Time ◽

Harmonic Scalpel ◽

Postoperative Bleeding ◽

Growth Time ◽

Recurrent Tonsillitis ◽

Intraoperative Bleeding ◽

Significant Difference ◽

Double Blinded ◽

Cold Dissection

Objectives: To compare the safety and effectiveness of tonsillectomy with three different techniques. Design: A double-blinded randomized prospective clinical trial Setting and Participants: Totally120 patients with recurrent tonsillitis between April 2018 and April 2020 were included. Main Outcome Measures: Operative time, intra and post operative bleeding loss, pseudomembrane growth time, pseudomembrane shedding time, postoperative pain, and necrosis depth of specimens were compared of harmonic scalpel(HS), coblation and cold dissection(CD) tonsillectomy. Results: The operative time and intraoperative bleeding loss was significantly less in HS and coblation group than CD group(p < 0.05). Pseudomembrane growth time and pseudomembrane shedding time were significantly longer in the HS group compared with the other groups(p < 0.05). The postoperative pain levels were significantly higher on the first postoperative day in CD group(p < 0.05), and significantly lower on the third and seventh postoperative day in coblation group(p < 0.05). There was no significant difference among three techniques in terms of postoperative bleeding loss(p > 0.05). The deepest necrosis depth in specimen was found in HS group(p > 0.05), while in CD group, only edema was observed without necrosis. Conclusion: To compared with HS and CD, coblation is a faster, safer and more painless technique for tonsillectomy in adult.

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Dexmedetomidine decreased the post‐thyroidectomy bleeding by reducing cough and emergence agitation – a randomized, double‐blind, controlled study

BMC Anesthesiology ◽

10.1186/s12871-021-01325-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sang Hun Kim ◽

Yoo Seok Kim ◽

Seongcheol Kim ◽

Ki Tae Jung

Keyword(s):

Postoperative Bleeding ◽

Postoperative Hemorrhage ◽

Controlled Study ◽

Emergence Agitation ◽

Double Blind ◽

Extubation Time ◽

Registration Number ◽

Recovery From Anesthesia ◽

Postanesthetic Care Unit ◽

Group D

Abstract Background Bleeding after thyroidectomy occurs due to violent coughing during emergence. Dexmedetomidine is helpful for the smooth emergence and suppression of cough. The purpose of the present study was to compare the effects of dexmedetomidine on postoperative bleeding after thyroidectomy. Methods Randomized, double-blind, controlled trials were conducted in female patients (ASA I–II, aged 20 to 60 years). The patients were randomly allocated into two groups. Approximately 15 min before the end of the surgery, dexmedetomidine was administered (0.6 µg/kg/h) without a loading dose in group D (n = 69), and normal saline was administered in group S (n = 70) at the same infusion rate. Hemodynamic data, coughing reflex, extubation time, Ramsay sedation scale (RSS), and recovery time were assessed during the administration of the study drugs and recovery from anesthesia. The amount of postoperative hemorrhage was measured for 3 days. Results Data from a total of 139 patients were analyzed. The incidence of severe cough was significantly lower in group D than in group S (4.3 % vs. 11.5 %, P = 0.022). The emergence agitation in the postanesthetic care unit was significantly lower in group D than in group S (P = 0.01). Postoperative bleeding was significantly lower in group D than in group S until the second postoperative day (P = 0.015). Conclusions Dexmedetomidine can be helpful in decreasing bleeding after thyroidectomy by reducing coughing and emergence agitation. Trial registration This study was registered at http://clinicaltrials.gov (registration number NCT02412150, 09/04/2015).

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Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy

KYAMC Journal ◽

10.3329/kyamcj.v10i1.41478 ◽

2019 ◽

Vol 10 (1) ◽

pp. 21-24

Author(s):

Md Abdus Salam ◽

Md Mahbub Alam ◽

Rezwan Ahmed ◽

Md Sultan Mahmud

Keyword(s):

Postoperative Pain ◽

Postoperative Bleeding ◽

Throat Pain ◽

Medical College ◽

Advantages And Disadvantages ◽

Case Surgery ◽

Group A ◽

The Difference ◽

Group B ◽

Dissection Method

Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for different indications. Tonsillectomy is often performed as day-case surgery, which increases the demands of a satisfactory postoperative pain control and a low risk of early postoperative bleeding. Objective: The aim of the study was to compare the Monopolar diathermy and Dissection methods of tonsillectomy and evaluate their advantages and disadvantages during surgery, convalescence. Materials and Methods: Two hundred children were recruited for this study during the period of five years from January, 2014 to December, 2018 at Otolaryngology department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). Subjects between the age of 5 and 25 years listed for tonsillectomy were included. Subjects were recommended not to have aspirin within the 2 weeks before surgery. Results: The mean duration of operation was found 10.6±0.4 minutes in group A and 17.0±0.7 minutes in group B. The difference was statistically significant (p<0.05) between two groups. At 1st day, 11(11.0%) patients had throat pain in group A and 23(23.0%) in group B. At 2nd day, 14(14.0%) patients had throat pain in group A and 25(25.0%) in group B. Which were statistically significant (p<0.05) between two groups. Conclusion: The monopolar diathermy tonsillectomy appears to cause less bleeding, postoperative pain and less time consuming in compare with the dissection tonsillectomy although patients experience slightly more pain than dissection Method. KYAMC Journal Vol. 10, No.-1, April 2019, Page 21-24

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Abdominoplasty Using Nd-YAG Contact Tip Laser

The American Journal of Cosmetic Surgery ◽

10.1177/074880689501200108 ◽

1995 ◽

Vol 12 (1) ◽

pp. 41-48 ◽

Cited By ~ 2

Author(s):

Jung I. Park

Keyword(s):

Pulmonary Embolism ◽

Postoperative Pain ◽

Surgical Procedure ◽

Postoperative Bleeding ◽

Compact Model ◽

Excessive Bleeding ◽

Cosmetic Procedure ◽

Laser Technology ◽

Tissue Handling ◽

Tissue Dissection

Abdominoplasty is a relatively major cosmetic procedure with associated complications such as excessive bleeding, hematoma, seroma formation, infection, and pulmonary embolism, etc. Complete hemostasis and gentle tissue handling are of paramount importance to avoid stated complications. The application of laser technology had given us opportunities to achieve these goals by drastically reducing intraoperative and postoperative bleeding, by sealing the lymphatic capillaries and by allowing a gentle tissue dissection. The laser physics, its clinical application, the surgical procedure, and patient photographs are presented. The Nd-YAG contact tip laser allowed us to perform surgery with almost absolute hemostasis. Recovery from surgery has been rapid due to less postoperative pain. The expense of laser use has been reduced significantly by the introduction of a compact model with less wattage for office use.

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