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Postoperative quality of life after two different methods of tonsillectomy

Postoperative Lebensqualität von Kindern nach zwei verschiedenen Methoden der Tonsillektomie

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Summary

Background and objectives

Tonsillectomy is a very painful procedure. Pain may be severe, and patients are often unable to perform in school or eat regular food for a number of days after the surgery. The aim of this study was to compare the quality of life after undergoing two different surgical techniques of tonsillectomy, harmonic scalpel and classic tonsillectomy with bipolar cauterization.

Design and setting

Prospective randomized double-blind, clinical trial study conducted in the ENT Department, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia.

Patients and methods

Data were collected, according to the type of operation, on pain persistence and intensity and returning to normal eating with tonsillectomy patients during the first seven postoperative days. Group A consisted of 50 children submitted to classic tonsillectomy with bipolar cauterization, while group B included 50 children operated on using the harmonic scalpel. Data on pain intensity were obtained using pain measuring scales adjusted to children’s age (Faces scales, visual analog scale). The first day of normal oral food intake was recorded.

Results

The analysis of variance revealed that the grade of pain significantly differs by a surgical technique employed, and that it significantly varied over the first seven postoperative days. The pain was more severe after undergoing the harmonic scalpel technique and children started to eat later compared with the classic tonsillectomy.

Conclusion

The classic tonsillectomy method with bipolar cauterization is the method of choice due to lower postoperative pain levels and sooner normal eating. The quality of life is better after undergoing the classic tonsillectomy method.

Zusammenfassung

Hintergrund und Ziele

Eine Tonsillektomie ist eine sehr schmerzhafte Prozedur. Der Schmerz kann sehr ausgeprägt sein. Die Kinder müssen oft mehrere Tage der Schule fern bleiben. Sie sind oft mehrere Tage nicht in der Lage, ein normales Essen zu sich nehmen. Ziel dieser Studie war es, die Lebensqualität nach einer mit zwei verschiedenen chirurgischen Methoden (harmonisches Skalpell versus klassische Methode einer bipolaren Kauterisierung) durchgeführten Tonsillektomie zu vergleichen.

Studiendesign

Prospektiv randomisierte Doppelblindstudie. Die klinische Studie wurde an der HNO Abteilung des Dr. Josip Benčević Allgemeinen Krankenhauses, Slavonski Brod, Kroatien durchgeführt.

Patienten und Methoden

Die Daten wurden entsprechend dem Operationstyp gesammelt. Erhoben wurde die Schmerzpersistenz und Intensität während der ersten sieben postoperativen Tage sowie die Zeit bis zur Wiederkehr zu normaler Nahrungsaufnahme. Die Gruppe A bestand aus 50 Kindern, die einer klassischen Tonsillektomie unterworfen wurden, die Gruppe B aus 50 Kindern, die eine Tonsillektomie mittels des klassischen Skalpells hinter sich hatten. Die Schmerzintensität wurde mittels einer für Kinder adaptierten Schmerzskala (Gesichts-Skala, visuelle Analog-Skala). Der erste Tag einer normalen Nahrungsaufnahme wurde festgehalten.

Ergebnisse

Die Varianzanalyse zeigte, dass der Grad des Schmerzes signifikant mit der chirurgischen Technik variierte und dass diese auch die ersten sieben postoperativen signifikant unterschiedlich war. Der Schmerz war nach den Tonsillektomien, die mittels der harmonischen Skalpell-Technik durchgeführt worden waren, ausgeprägter als nach Einsatz der klassischen Tonsillektomie-Technik Auch die normale Nahrungsaufnahme setzte bei der Gruppe, bei der das harmonische Skalpell angewandt wurde, später ein. Die Lebensqualität ist nach der klassischen Tonsillektomie besser als nach Einsatz der Technik des harmonischen Skalpells.

Schlussfolgerung

Die klassische Tonsillektomie mit bipolarer Kauterisation ist die Methode der Wahl, da die postoperativen Schmerzen geringer sind und die Kinder früher wieder normal Nahrung zu sich nehmen können.

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Conflict of interest

The authors declare that there is no actual or potential conflict of interest in relation to this article.

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Authors and Affiliations

  1. Department of ENT, Head and Neck Surgery, General Hospital Dr. Josip Benčević, Andrije Štampara 42, 35000, Slavonski Brod, Croatia

    Ivana Pajić-Penavić MD, PhD &  Davorin Đanić MD, PhD

  2. Department of Anesthesia and Resuscitation, General Hospital Dr. Josip Benčević, Slavonski Brod, Croatia

    Natalija Mrzljak-Vučinić MD &  Ivo Matić MD, PhD

  3. Department of Ophtalmology, General Hospital Dr Josip Bečević, Slavonski Brod, Croatia

    Željka Vuković-Arar MD

  4. Department of Neurology, General Hospital Dr. Josip Benčević, Slavonski Brod, Croatia

    Marinko Dikanović MD, PhD

Authors
  1. Ivana Pajić-Penavić MD, PhD
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  2. Davorin Đanić MD, PhD
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  3. Natalija Mrzljak-Vučinić MD
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  4. Ivo Matić MD, PhD
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  5. Željka Vuković-Arar MD
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  6. Marinko Dikanović MD, PhD
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Corresponding author

Correspondence to Ivana Pajić-Penavić MD, PhD.

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Pajić-Penavić, I., Đanić, D., Mrzljak-Vučinić, N. et al. Postoperative quality of life after two different methods of tonsillectomy. Wien Klin Wochenschr 125, 524–528 (2013). https://doi.org/10.1007/s00508-013-0411-6

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  • DOI: https://doi.org/10.1007/s00508-013-0411-6

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