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

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

<p class="abstract"><strong>Background:</strong> The objective of this study is to compare operative time, intraoperative bleeding, postoperative pain between coblation and dissection tonsillectomy.</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>

scholarly journals A novel electrosurgical divider: performance in a self-controlled tonsillectomy study

2021 ◽  
Author(s):  
Gerold Besser ◽  
Stefan Grasl ◽  
Elias L. Meyer ◽  
Julia Schnoell ◽  
Tina J. Bartosik ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Postoperative Bleeding ◽  
Neck Surgery ◽  
Controlled Clinical Trial ◽  
Intraoperative Blood Loss ◽  
Bleeding Events ◽  
Surgical Time ◽  
Secondary Bleeding ◽  
Temperature Controlled

Abstract Purpose Tonsillectomies are among the most common surgeries in otorhinolaryngology. A novel electrosurgical temperature-controlled instrument (device) promises rapid tonsillectomies and might reduce postoperative pain, but comparative studies to assess performance are warranted. Methods This randomized self-controlled clinical trial was conducted from October 2019 to October 2020 at the Department of Otorhinolaryngology, Head and Neck Surgery of the Medical University of Vienna. Forty-eight patients underwent a tonsillectomy with the device on one side and using cold-steel with localized bipolar cauterization on the other side (control). Main outcomes were the time for tonsil removal (per side) and the time to stop bleeding (per side). Secondary measurements were postoperative pain, assessed once on day 0 and five times on days 1, 3, 5, 7, and 10. Postoperative bleeding episodes and consequences were recorded. Results Device tonsillectomies were performed significantly faster than controls; the mean surgical time difference was 209 s (p < 0.001, 95% CI 129; 288). Intraoperative blood loss was significantly lower on the device side (all p < 0.05). Postoperative measurements of pain and bleeding were similar for both sides. Two return-to-theatre secondary bleeding events were recorded for the control side. Conclusion The novel electrosurgical temperature-controlled divider reduced the tonsillectomy surgical time and intraoperative blood loss, with no apparent negative effects on postoperative pain or bleeding, compared to a cold-steel tonsillectomy with localized bipolar cauterization. In time-restricted settings, the device could be beneficial, particularly after familiarization with device handling. Trial registration ClinicalTrials.gov Identifier: < Blinded for review > 

Comparison of Postoperative Pain and Application Effect of High Tibial Osteotomy and Total Knee Replacement in Patients with Knee Arthritis

2021 ◽  
Vol 7 (5) ◽  
pp. 4013-4020
Author(s):  
Bingtao Shi ◽  
Wentao Gao ◽  
Haifang Li
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Knee Joint ◽  
Total Knee Replacement ◽  
Operative Time ◽  
Tibial Osteotomy ◽  
Intraoperative Blood Loss ◽  
Knee Arthritis ◽  
Total Knee ◽  
Better Than

Objective: To investigate the effects of high tibial osteotomy (HTO) and total knee replacement (TKR) on postoperative pain of patients with knee arthritis. Methods: From February 2017 to March 2019, 72 patients with knee arthritis in our unit were collected for the experiment. Patients in the control group (CG, 35 cases) were treated with HTO, and research group (RG, 37 cases) were treated with TKR. Clinical efficacy. Visual Analogue Scale (VAS) score. Knee Society Score (KSS), and Hospital for Special Surgery (HSS) knee rating score of the two groups of patients were observed. Intraoperative blood loss, operative time and hospitalization expenses were observed, as well as the effect of knee joint recovery after operation. Results: In terms of overall effective rate, RG was superior to CG (p < 0.05). VAS score of RG was notably lower at 1 week and 2 weeks after operation than that in CG (p < 0.05). KSS of RG was evidently higher than that of CG (p < 0.05). HSS score of RG was notably higher than that of CG after operation (p < 0.05). The intraoperative blood loss and operative time in RG were notably better than those in CG (p < 0.05). The effects of knee joint recovery in RG was considerably better than that in CG (p < 0.05). Conclusion: TKR has a better clinical effect on elderly patients, which can reduce postoperative pain, intraoperative blood loss and operative time, and improve the recovery effect of knee joint.

scholarly journals Comparison of Ultrasonic Device Versus Bipolar Diathermy Tonsillectomy in Children

2019 ◽  
Vol 17 (01) ◽  
pp. 71-75
Author(s):  
Mukesh Kumar Sah ◽  
Yogesh Neupane ◽  
Rajendra Prasad Guragain
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Intraoperative Blood Loss ◽  
Bipolar Diathermy ◽  
Analog Scale ◽  
Intraoperative Bleeding ◽  
Ultrasonic Device ◽  
Post Operative Pain ◽  
The Mean ◽  
Group Post

Background: Intraoperative bleeding and postoperative pain are two commonest concerns for both patient and surgeon in tonsillectomy. This study was aimed to compare intraoperative blood loss and early postoperative pain between ultrasonic device and bipolar diathermy tonsillectomy in children.Methods: Prospective, interventional, single blinded, comparative study was carried out from September 2016 to September 2017 including children up to age 15 years who underwent tonsillectomy either by bipolar diathermy or ultrasonic device. Intraoperative blood loss was recorded using standard sized gauge technique. Post-tonsillectomy pain on first five postoperative days (early postoperative pain) was assessed using Visual analog scale for children older than 5 years and FLACC score for children up to 5 years respectively.Means were compared.Results: 38 children (76 tonsils) were included in the study out of which 31 were boys (62 tonsils) and 7 were girls (14 tonsils). The mean intraoperative blood loss in ultrasonic dissection group was 13.94 ml and 13.91 ml in bipolar diathermy group. This difference was not statistically significant (p=0.974). Post-operative pain on 1st, 2nd, 3rd and 4th days were significantly less (p<0.05) in ultrasonic device group compared to bipolar diathermy group. Post-operative pain was less also on 5th post-operative day in ultrasonic device but was not statistically significant (p=0.172).Conclusions: Tonsillectomy in children using ultrasonic device did not differ from bipolar diathermy tonsillectomy in respect to intraoperative blood loss. However, early postoperative pain was significantly lower in ultrasonic device group.Keywords: Bipolar diathermy; tonsillectomy; ultrasonic device.

Effect of Modern Fibrin Glue on Bleeding after Tonsillectomy and Adenoidectomy

2003 ◽  
Vol 112 (5) ◽  
pp. 410-414 ◽  
Author(s):  
Michael Vaiman ◽  
Nathan Shlamkovich ◽  
Efraim Eviatar ◽  
Samuel Segal
Keyword(s):  
Blood Loss ◽  
Fibrin Glue ◽  
Randomized Study ◽  
Postoperative Bleeding ◽  
Postoperative Hemorrhage ◽  
Control Group ◽  
Surgical Trauma ◽  
Intraoperative Blood Loss ◽  
Secondary Hemorrhage ◽  
Needle Point

We performed a prospective randomized study in 179 patients to examine the second-generation surgical fibrin sealant Quixil as an effective substitute for different types of electrocautery in tonsillectomy and adenoidectomy. We compared the rates of hemorrhagic complications in a group with bipolar or needle point electrocautery and in a group in whom fibrin glue was used to stop intraoperative bleeding and to prevent postoperative bleeding. The operations were performed under general anesthesia in typical fashion with sharp dissection. For the control group, hemostasis was achieved by bipolar or needle point electrocautery. For the fibrin glue group, hemostasis was achieved by spraying Quixil fibrin glue approximately 0.5 mL to each tonsillar fossa and 0.5 mL to the nasopharynx (in adenoidectomy). The results were excellent in all the patients of the fibrin glue group, with complete hemostasis and resolution of the major symptoms. In this group, the intraoperative blood loss averaged 15 mL in tonsillectomy and 9 mL in adenoidectomy. There were no cases of postoperative hemorrhage or any other complications. The electrocautery group required a longer time for healing, and its intraoperative blood loss (tonsillectomy) averaged 29 to 33 mL. The incidence of posttonsillectomy bleeding in this group was 4.35% (4 patients). Three patients (3.26%) had primary hemorrhage (bleeding that occurs within the first 24 hours of surgery), and 1 patient (1.09%) had secondary hemorrhage (bleeding that occurs after the first 24 hours). We conclude that Quixil fibrin glue application to the operative sites in tonsillectomy and adenoidectomy provides effective hemostasis and sealing with good systemic and local compatibility. With the help of Quixil, we minimized surgical trauma and achieved absolute hemostasis at the same time. We found this fibrin glue to be a more convenient and effective hemostatic sealant than bipolar or needle point coagulation.

scholarly journals Coblation Versus Diode Laser Tonsillectomy: A Comparative Study

2021 ◽  
Author(s):  
Ameer A. Alaqeedy ◽  
Rasheed Ali Rashid ◽  
Raid M. Al-Ani
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Comparative Study ◽  
Diode Laser ◽  
Operative Time ◽  
Postoperative Bleeding ◽  
P Value ◽  
Intraoperative Blood Loss ◽  
Laser Technique ◽  
Significant Difference

Abstract Introduction: The study aimed to compare the 2 procedures of tonsillectomy (coblation and diode laser) concerning the operative time, the amount of blood loss, postoperative pain, and other complications. Materials and Methods: A comparative study was conducted at many Private Hospitals, Baghdad, Iraq from February 2019- February 2020. Coblation and laser tonsillectomy were performed on the same patient (one for each side) which was blinded to the patients or their caregivers and the surgeon who did the tonsillectomy. Data concerning the age, gender, indications for tonsillectomy, operative time, the amount of the blood loss, post-tonsillectomy pain by VAS scores, and other complications were recorded for each patient. Results: Out of 62 participants, there were 34 (54.8%) females. The majority were from the age group ≤18 years (n=54, 87.1%). The operative time and amount of the intraoperative blood loss were significantly lower in the coblation than a diode laser tonsillectomy. However, the postoperative pain scores in the diode laser were a statistically significant difference less than the coblation group at the periods 3 hours, 8 hours, 24 hours, and 7 days (P-value<0.05). While there was no statistically significant difference between the two groups at 2 weeks postoperative period (P-value=0.392). No primary or secondary postoperative bleeding in all patients. Conclusion: coblation was better than diode laser because of shorter operative time and less intraoperative blood loss. However, the diode laser technique had lesser postoperative pain at the postoperative periods 3 hours, 8 hours, 24 hours, and 7 days than coblation.

scholarly journals Comparison of Labetalol and Nitroglycerine on Intraoperative Bleeding in Patients Who Underwent Dacryocystorhinostomy

2020 ◽  
Author(s):  
Mehdi Sanatkar ◽  
Alireza Ebrahim Soltani ◽  
Alireza Takzare
Keyword(s):  
Blood Loss ◽  
Scoring System ◽  
Randomized Study ◽  
Group Versus ◽  
Category Scale ◽  
Intraoperative Bleeding ◽  
Time Of Operation ◽  
Surgeon Satisfaction ◽  
Surgical Condition ◽  
Better Than

The bleeding during dacryocystorhinostomy (DCR) surgery is one of the main complications that led to the surgeon’s dissatisfaction and increased the duration of the operation. The current study aimed at comparing the effects of labetalol and nitroglycerine (TNG) on blood loss and the surgeon’s satisfaction during DCR. The current prospective and randomized study enrolled 60 patients candidate for DCR under local anesthesia and sedation and divided into two groups. When the surgeon dissatisfied with bleeding during the operation, patients in the labetalol group received labetalol infusion at a rate of 0.5-2 mg/kg and compared with the subjects in the TNG group that received TNG infusion at a rate of 0.1 µg/kg/min. Additionally, the surgical condition was assessed by the surgeon using the average category scale (ACS) and surgeon’s satisfaction by a scoring system. The average bleeding in the labetalol group was 140.5±24.5 ml versus 170.4±24.6 ml in the TNG group, respectively (P=0.001). The average category scale for the labetalol group was better than the TNG group during all the time of operation. The surgeon satisfaction score during the operation was more in the labetalol group (3.4 in the labetalol group versus 2.8 in the TNG group, respectively). Labetalol was better than TNG for controlling bleeding during DCR procedure because of decreasing surgical blood loss and optimum operative condition.

scholarly journals Does tranexamic acid have role in controlling intraoperative blood loss in tonsillectomy?

2020 ◽  
Vol 6 (7) ◽  
pp. 1253
Author(s):  
Heempali Das Dutta ◽  
Pabina Rayamajhi ◽  
Nazeef Ibrahim
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Postoperative Bleeding ◽  
University Teaching ◽  
Control Group ◽  
Study Group ◽  
Intraoperative Blood Loss ◽  
Intraoperative Bleeding ◽  
The Difference ◽  
And Control

<p class="abstract"><strong>Background:</strong> The study was done with the objective to assess the effect of tranexamic acid in controlling intraoperative bleeding in tonsillectomy.</p><p class="abstract"><strong>Methods:</strong> Retrospective study was conducted in the Department of ENT and HNS, Tribhuvan University Teaching Hospital, Kathmandu, Nepal from August 2016 to July 2017. Patients more than 15 years who underwent bilateral tonsillectomy were included in the study. Whereas patients who underwent unilateral tonsillectomy and patients who had hypersensitivity to tranexamic acid were excluded from the study. The patients who received tranexamic acid during surgery were taken as study group whereas the patients who didn’t receive tranexamic acid were taken as control. The amount of the intraoperative blood loss, i.e. mean and the frequency of early post-operative bleeding were evaluated.  </p><p class="abstract"><strong>Results:</strong> A total of 48 patients who fulfilled the inclusion criteria were evaluated. Among whom, 24 patients who received tranexamic acid during tonsillectomy were taken as study group and other 24 patients who did not received tranexamic acid were taken as control. The mean blood loss in study and control group were 92.85 ml and 91.40 ml respectively and the difference was statistically not significant (p=0.785). There were no cases of early postoperative bleeding recorded in either group within the first 24 hours of surgery.</p><p><strong>Conclusions:</strong> There is no significant role of tranexamic acid in controlling intraoperative bleeding in tonsillectomy. </p>

Can Dexmedetomidine Influence Recovery Profiles from General Anesthesia in Nasal Surgery?

2017 ◽  
Vol 158 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Ho Seok Lee ◽  
Ho Young Yoon ◽  
Ho Jun Jin ◽  
Se Hwan Hwang
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
General Anesthesia ◽  
Meta Analysis ◽  
Nausea And Vomiting ◽  
Intraoperative Blood Loss ◽  
Emergence Agitation ◽  
Nasal Surgery ◽  
Surgical Time ◽  
Inhaled Anesthetic

Objectives Dexmedetomidine has sympatholytic, sedative, anesthetic, and analgesic effects, as well as vasoconstrictive effects, which may help prevent hypotension under general anesthesia. This meta-analysis aimed to perform a systematic review of the literature and investigate the effect of dexmedetomidine on perioperative morbidity following nasal surgery and its adverse effects. Data Sources MEDLINE, SCOPUS, and the Cochrane database. Review Methods Two authors independently searched the databases from their inception to March 2017. Studies were selected that compared perioperative dexmedetomidine administration (dexmedetomidine groups) with a placebo or remifentanil (control groups) with regard to intraoperative morbidity, including surgical time, bleeding amount, hypotension, and bradycardia during operation, and postoperative morbidity, such as emergence agitation, nausea and vomiting, and sedation after operation. Results Surgical time, intraoperative blood loss, dose of inhaled anesthetic gas, dose of fentanyl, postoperative pain, and incidence of emergence agitation were significantly lower in the dexmedetomidine group versus the placebo group. In contrast, there were no significant differences in intraoperative hemodynamic stability and postoperative residual sedation and nausea and vomiting between groups. Additionally, compared with remifentanil (a currently widely used agent), dexmedetomidine was superior in view of postoperative pain and intraoperative blood pressure control. Conclusion This meta-analysis shows that the systemic administration of dexmedetomidine can decrease surgical time, intraoperative blood loss, and doses of intraoperative inhaled anesthetic gas and fentanyl as compared with placebo. It can also decrease postoperative pain and incidence of the emergence agitation. Due to the small number of studies, further clinical trials are needed to confirm these results.

THE FEASIBILITY OF FAST TRACK PROTOCOL FOR ELDERELY PATIENTS WITH COLORECTAL CANCER

2016 ◽  
pp. 26-29
Author(s):  
D. . Zitta ◽  
V. . Subbotin ◽  
Y. . Busirev
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Surgery ◽  
Blood Loss ◽  
Elderly Patients ◽  
Fast Track ◽  
Randomized Study ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Elective Colorectal Surgery ◽  
Complications Rate

Fast track protocol is widely used in major colorectal surgery. It decreases operative stress, shortens hospital stay and reduces complications rate. However feasibility and safety of this approach is still controversial in patients older than 70 years. The AIM of the study was to estimate the safety and effectiveness of fast track protocol in elderly patients with colorectal cancer. MATERIALS AND METHODS. Prospective randomized study included 138 elective colorectal resectionfor cancer during period from 1.01.10 till 1.06.15. The main criteria for the patients selection were age over 70 years and diagnosis of colorectal cancer. 82 of these patients received perioperative treatment according to fast track protocol, other 56 had conventional perioperative care. Patients underwent following procedures: right hemicolectomy (n=7), left hemicolectomy (n=12), transverse colectomy (n=1), sigmoidectomy (n=23), abdomeno-perineal excision (n=19) and low anterior resection of rectum (n=76). Following data were analized: duration of operation, intraoperative blood loss, time offirst flatus and defecation, complications rates. RESULTS. Mean age was 77,4 ± 8 years. There were no differences in gender, co morbidities, body mass index, types of operations between groups. Duration of operations didn't differ significantly between 2 groups. Intraoperative blood loss was higher in conventional group. The time of first flatus and defecation were better in FT-group. There was no mortality in FT-group vs 1,8 %o mortality in conventional group. Complications rate was lower in FT-group: wound infections 3,6% vs 9 %, anastomotic leakage 4,8 %o vs 9 %o, ileus 1,2 vs 5,4 %o, peritonitis 2,4 %o vs 3,6%o, bowel obstruction caused by the adhesions 6 % vs 5,3 %. Reoperation rate was similar 4,8 % vs 3,6 %. CONCLUSION. Fast track protocol in major elective colorectal surgery can be safely applied in elderly patients. The application of fast track protocol in elderly patients improves the restoration of bowel function and reduces the risk of postoperative complication.

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