A Comparison of Tonsillectomy with the Harmonic Scalpel versus Electrocautery

Abstract

OBJECTIVE: We sought to test whether the use of the harmonic scalpel would cause less pain and more rapid recovery in tonsillectomy patients versus the use of electrocautery. DESIGN AND SETTING: In a private practice community hospital, we conducted a prospective nonrandomized comparison of 156 pediatric tonsillectomy cases. Local anesthetic infiltrations and steroids were used at the discretion of the surgeon. Outcome variables consisted primarily of immediate-and mid-term pain, pain medications required, time to eating, morbidities and charges. RESULTS: There were no differences between the groups on an intention-to-treat basis except for costs, which were higher in the harmonic scalpel group. When rescue use of electrocautery was required to control bleeding in the in the harmonic scalpel patients, more pain and longer times to taking food were noted. CONCLUSIONS: Used with discretion the harmonic scalpel is equivalent to electrocautery for tonsillectomy. SIGNIFICANCE: The harmonic scalpel does not provide a major benefit over more conventional methods of tonsillectomy.