Comparison Between Bipolar Diathermy and Coblation Assisted Tonsillectomy in Pediatric Population: A Randomized Experimental Study

ABSTRACT Background and Aim Tonsillectomy is one of the most commonly performed surgical procedures on children. Indications for tonsillectomy include recurrent tonsillitis, obstructive sleep apnea, and peritonsillar abscess, among others. Bipolar diathermy and coblation surgeries are the most common used surgeries. Bipolar Diathermy efficiently manages postoperative hemorrhage but often results in increased postoperative pain due to higher thermal tissue destruction. In contrast, coblation is a procedure that offers a lower output of heat and results in lesser pain and shorter healing times. The present study compares the above two procedures to evaluate the postoperative outcomes regarding pain, healing, and safety of pediatric tonsillectomy patients. Methods This was a prospective, randomized, experimental study on 120 pediatric patients ranging from 5 to 14 years who experienced recurrent or chronic tonsillitis or obstructive symptoms, amongst them sleep apnea. Both groups were operated on with extracapsular tonsillectomy under general anaesthesia, with standardized preoperative management and uniform anaesthetic protocols. The aforementioned parameters of pain, hemorrhage, and healing process were similarly followed up for postoperative evaluations at one, two, three, and 4 weeks. Results Mean scores of pain were very highly significantly lower in patients of Group A at visits than in patients of Group B. Patients of Group A received scores for visit for the first week at 9.45 ± 0.58 versus 9.82 ± 0.22 (p = 0.001) and scores for visit in the fourth week at 0.35 ± 0.40 versus 1.92 ± 1.78 (p = 0.001). Group A compared with group B had early healing time and fewer cases of bleeding complications. Time to pain resolution was shorter in Group A with a mean of 15.5 ± 2.0 days compared with a mean of 24.8 ± 3.4 days in Group B, (p = 0.001). Conclusion The study results show that in pediatric patients, coblation‐assisted tonsillectomy proved to have advantageous benefits over bipolar diathermy tonsillectomy. Coblation provided less postoperative pain and quick healing, with an overall shorter pain duration and fewer bleeding complications.