scholarly journals Comparision of Coblation and Cold Dissection Techniques outcome among Tonsillectomy patients at Birat Medical College and Teaching Hospital

2021 ◽  
Vol 23 (3) ◽  
pp. 198-203
Author(s):  
Bipin Koirala ◽  
R.K. Shah ◽  
K. Shrestha ◽  
S. Sapkota
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Teaching Hospital ◽  
Operative Time ◽  
Postoperative Bleeding ◽  
Postoperative Blood Loss ◽  
Early Recovery ◽  
Medical College ◽  
Dissection Techniques ◽  
Cold Dissection

Tonsillectomy is the most commonly performed surgery. Cold dissection tonsillectomy remains as the gold standard for tonsil removal, although it may increase risk for complication. Coblation tonsillectomy is a new technique .There are studies comparing these two method of surgery and have shown coblation technique to cause less postoperative pain, less intra operative time along with less intra and postoperative blood loss. In contrary few studies have shown it to be ineffective in reducing postoperative bleeding. Hence more studies are still required. Thus the objective of the present study was to compare coblation and cold dissection techniques outcome among tonsillectomy patients at Birat Medical College and Teaching Hospital. The study intended to determine and compare the intraoperative time, intra operative blood loss and postoperative pain in coblation and cold dissection tonsillectomy. This is a hospital based cross sectional comparative study. Eighty six patients underwent tonsillectomy during the study period of one year (15th Feb 2020 to 14th Feb 2021) in the department of ENT HNS, Birat Medical College and Teaching Hospital. Among 86 patients, 43 underwent cold dissection and 43 coblation tonsillectomy. Method of surgery was based on odd and even serial number of the patients during presentation. This study showed that intra operative time, intraoperative blood loss and post operative pain score was 16.77±2.7mins, 36.51±128ml and 6.28 respectively in coblation method and 37.84±3.1 mins, 101.4±12.7ml and 7.88 respectively in cold dissection method. Hence coblation method is a safer and effective method of tonsillectomy compared to cold dissection which ultimately leads to less post operative analgesics demands and early recovery.

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.

Bipolar Radiofrequency Dissection Tonsillectomy: A Prospective Randomized Trial

2005 ◽  
Vol 133 (6) ◽  
pp. 961-965 ◽  
Author(s):  
Sameh M. Ragab
Keyword(s):  
Postoperative Pain ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Operative Time ◽  
Operating Time ◽  
Controlled Study ◽  
Operative Blood Loss ◽  
Bipolar Radiofrequency ◽  
Significant Difference ◽  
Cold Dissection

OBJECTIVES: To conduct a prospective randomized controlled study presenting and comparing bipolar radiofrequency dissection tonsillectomy (BRDT) to cold dissection tonsillectomy (CDT) regarding intra-operative blood loss, operative time, postoperative pain, and postoperative complications including hemorrhage. MATERIALS AND METHODS: From January 2004 to March 2005, 200 children planned to undergo tonsillectomy were included in this study. Children were prospectively randomized into two equal groups: bipolar radiofrequency dissection tonsillectomy and cold dissection tonsillectomy. The operative time and intraoperative blood loss were recorded. Children were asked to record their pain on a standardized visual analog scale on days 1, 4, 7, and 14. All children were reviewed on the 4th, 7th, and 14th day after surgery. Postoperative complications were recorded and dealt with. RESULTS: There was a shorter operative time (mean 8.5 minutes, P < 0.001) in the radiofrequency group. BRDT showed a decrease of 7 minutes in the mean when compared to the CDT group. The amount of blood lost during BRDT was minimal (mean 13 cc), with a mean difference of 69 cc when compared to CDT ( P < 0.001). There was no statistical significant difference in pain score between the two groups except in the first postoperative day where the BRDT demonstrated a statistically significant lower parameters ( P < 0.05). No evidence for statistically significant difference between the two groups regarding postoperative complications. CONCLUSION: BRDT is a new, easy, and safe technique that offers a complete eradication of the tonsillar disease, short operating time, minimal intra-operative blood loss, and a suitable cost with no additional increase in postoperative pain and hemorrhage when compared to the conventional CDT. Our experience promotes BRDT as the preferred method of tonsillectomy. EBM RATING: A

Coblation versus cold dissection in paediatric tonsillectomy: a systematic review and meta-analysis

2020 ◽  
Vol 134 (3) ◽  
pp. 197-204
Author(s):  
M U Ahmad ◽  
A N Wardak ◽  
T Hampton ◽  
M R S Siddiqui ◽  
I Street
Keyword(s):  
Systematic Review ◽  
Blood Loss ◽  
Operative Time ◽  
Meta Analysis ◽  
Alternative Technique ◽  
Operative Blood Loss ◽  
Operative Outcomes ◽  
Significant Difference ◽  
Dissection Techniques ◽  
Cold Dissection

AbstractBackgroundCold dissection is the most commonly used tonsillectomy technique, with low post-operative haemorrhage rates. Coblation is an alternative technique that may cause less pain, but could have higher post-operative haemorrhage rates.ObjectiveThis study evaluated the peri-operative outcomes in paediatric tonsillectomy patients by comparing coblation and cold dissection techniques.MethodsA systematic review was conducted of all comparative studies of paediatric coblation and cold dissection tonsillectomy, up to December 2018. Any studies with adults were excluded. Outcomes such as pain, operative time, and intra-operative, primary and secondary haemorrhages were recorded.ResultsSeven studies contributed to the summative outcome. Coblation tonsillectomy appeared to result in less pain, less intra-operative blood loss (p < 0.01) and a shorter operative time (p < 0.01). There was no significant difference between the two groups for post-operative haemorrhage (p > 0.05).ConclusionThe coblation tonsillectomy technique may offer better peri-operative outcomes when compared to cold dissection, and should therefore be offered in paediatric cases, before cold dissection tonsillectomy.

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

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.

scholarly journals Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy

KYAMC Journal ◽  
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

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 Influence of PAI-1 Gene Promoter-675 (4G/5G) Polymorphism on Fibrinolytic Activity After Cardiac Surgery Employing Cardiopulmonary Bypass

Medicina ◽  
2012 ◽  
Vol 48 (10) ◽  
pp. 75
Author(s):  
Agnese Ozolina ◽  
Eva Strike ◽  
Inta Jaunalksne ◽  
Jelena Serova ◽  
Tatjana Romanova ◽  
...  
Keyword(s):  
Blood Loss ◽  
Plasminogen Activator ◽  
Postoperative Bleeding ◽  
Gene Promoter ◽  
Plasminogen Activator Inhibitor ◽  
University Hospital ◽  
Postoperative Blood Loss ◽  
Bleeding Volume ◽  
Pai 1 ◽  
D Dimer

Background and Objective. The plasminogen activator inhibitor type-1 (PAI-1) gene promoter contains 675 (4G/5G) polymorphism. The aim of this study was evaluate the effect of the PAI-1 promoter-675 (4G/5G) polymorphism on the concentrations of PAI-1 and tissue plasminogen activator/PAI-1 (t-PA/PAI-1) complex and bleeding volume after on-pump cardiac surgery.Material and Methods. A total of 90 patients were included in the study at Pauls Stradins Clinical University Hospital. Seven patients were excluded due to surgical bleeding. Eighty-three patients were classified according to the PAI-1 genotype: 21 patients had the 4G/4G genotype; 42, the 4G/5G genotype; and 20, the 5G/5G genotype. The following fibrinolysis parameters were recorded: the PAI-1 level preoperatively, D-dimer level at 0, 6, and 24 hours after surgery, and t-PA/ PAI-1 complex level 24 hours postoperatively. A postoperative bleeding volume was registered in mL 24 hours after surgery.Results. The patients with the 5G/5G genotype had significantly lower preoperative PAI-1 levels (17 [SD, 10.8] vs. 24 ng/mL [SD, 9.6], P=0.04), higher D-dimer levels at 6 hours (371 [SD, 226] vs. 232 ng/mL [SD, 185], P=0.03) and 24 hours (326 [SD, 207] vs. 209 ng/mL [SD, 160], P=0.04), and greater postoperative blood loss (568 [SD, 192] vs. 432 mL [168], P=0.02) compared with the 4G/4G carriers. There were no significant differences in the levels of the t-PA/PAI-1 complex comparing different genotype groups.Conclusions. The carriers of the 5G/5G genotype showed the lower preoperative PAI-1 levels, greater chest tube blood loss, and higher D-dimer levels indicating that the 5G/5G carriers may have enhanced fibrinolysis.

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 > 

scholarly journals Perception and Attitudes of Medical Students Regarding Postoperative Pain Management

2021 ◽  
Author(s):  
Fatema Johora ◽  
Asma Akter Abbasy ◽  
Fatiha Tasmin Jeenia ◽  
Ferdaush Ahmed Sojib ◽  
Mohsena Aktar ◽  
...  
Keyword(s):  
Pain Management ◽  
Medical Students ◽  
Postoperative Pain ◽  
Essential Element ◽  
Postoperative Pain Management ◽  
Multimodal Analgesia ◽  
Treatment Modalities ◽  
Early Recovery ◽  
Medical College ◽  
Medical Colleges

Background: Postoperative pain remains a challenging problem, which requires a dynamic approach using a variety of treatment modalities to obtain an optimal outcome with respect to enhancing patient comfort and facilitating the recovery process. Multimodal analgesia signifies an increasingly popular approach to prevent postoperative pain. The approach includes administering a combination of opioid and nonopioid analgesics that act at different sites within the central and peripheral nervous systems in an effort to improve pain control while eliminating opioid-related adverse effects. Materials and Methods: To understand the perception and attitude of 4th year medical students, a structured questionnaire survey was done among six different medical colleges including government (Armed Forces Medical College, Cumilla Medical College and Colonel Malek Medical College, Manikganj) and non-government medical colleges (Army Medical College Bogura, Brahmanbaria Medical College and Chattogram International Medical College) of Bangladesh in October 2019. Total 340 students participated in the study. Result: Among the 340 students, almost 336 (98.2%) students were agreed that postoperative pain management is an essential element of patient care. Only 4 (1.18%) respondents disagreed. On the other hand, regarding its influence on early recovery and reduction of hospital staying, 311 (91.47%) respondents agreed and 29 (8.53%) respondents were found as disagreed. Regarding the issue of opioid commonly induced respiratory depression, 257 (75.59%) respondents thought it is a common adverse event and 81 (23.82%) respondents disagreed. 206 (60.59%) respondents did not agree that opioid always produce addiction or tolerance and 134 (39.71%) respondents disagreed with the same issue. 294 (86) respondents agreed that multimodal analgesia increases patients cost and 46 (14%) disagreed. 249 (74%) students agreed that regional techniques are useful for postoperative pain management and 89 (26%) respondents disagreed. Conclusion: Adequate post-operative pain management knowledge is necessary to reduce post-operative complications.

Sign in / Sign up

Export Citation Format

Share Document