The comparison of bleeding and pain after tonsillectomy in bipolar electrocautery vs cold dissection Mohammad Hossein Dadgarnia a , Mohammad Ali Aghaei a, * , Saeid Atighechi a , Nasim Behniafard a , Mohammad Reza Vahidi a , Mojtaba Meybodian a , Vahid Zand a , Maryam Vajihinejad b , Abdollah Ansari a a Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran b Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran article info Article history: Received 1 June 2016 Received in revised form 20 July 2016 Accepted 21 July 2016 Available online 26 July 2016 Keywords: Adenoidectomy Bleeding Tonsillectomy Pain Pediatrics Sleep-disorder Tonsillitis abstract Objective: Although tonsillectomy is one of the most common surgeries performed in pediatric, it has potential major complications such as pain and bleeding. This study aimed to compare the bleeding and pain after tonsillectomy in bipolar electrocautery tonsillectomy versus cold dissection. Methods: This double blind clinical trial was conducted on 70 pediatric patients who were candidate of tonsillectomy. Patients were divided into two groups of including bipolar cautery (BC) and cold dissec- tion (CD). operation time, intraoperative blood loss, and postoperative bleeding and pain were evaluated in the current study. Results: In both of the CD and BC groups, no significant difference was found in terms of sex and age. The average amount of the intraoperative blood loss in BC group was 14.086 ± 5.013 ml and in CD group was 26.14 ± 4.46 ml (p. v ¼ 0.0001). The mean time of operation in BC group was 19 ± 2.89 min and in CD group was 29.31 ± 5.29 min (p. v ¼ 0.0001). patients were evaluated in terms of pain on the first, third, fifth, and seventh days after the operation. No statistically significant difference was found between two groups. Moreover, Compared pain scores in all times across two groups, no significant difference was found. In terms of postoperative bleeding, none of the patients in both groups had bleeding during follow-up. Conclusion: Our study showed that bipolar electrocautery tonsillectomy can significantly reduce the operation time and intraoperative blood loss; however, postoperative pain and blood loss were similar in both techniques. We recommend bipolar electrocautery as the most suitable alternative method for tonsillectomy, especially in children. © 2016 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Although tonsillectomy is one of the most common surgeries performed in pediatric population, it has potential major compli- cations such as pain and bleeding [1]. These complications lead to the development of different techniques in adenoid tonsillitis sur- gery. Tonsillectomy via cold dissection is a traditional technique and newly introduced techniques include bipolar cautery, plasma excision (coblation), harmonic scalpel, powered intracapsular ton- sillectomy [2]. Monopolar tonsillectomy is preferred during the past three decades due to less operation time and better homeostasis during surgery. However, postoperative pain limits its use [2]. Theoreti- cally, bipolar cautery is preferred over monopolar electrocautery since it results in less tissue damage and consequently less post- operative pain while maintaining the benefits of using cautery for patients such as less intraoperative blood loss and operation time [3,4]. This study aimed to compare two techniques of bipolar elec- trocautery and cold dissection in terms of postoperative pain status, intraoperative bleeding, and postoperative bleeding in order to present a technique with least complication. * Corresponding author. Otorhinolaryngology Research Center, Shahid Sadoughi Hospital, Avicenna BLV., Safeyah, Yazd, Iran. E-mail address: drmohammadaliaghaei@gmail.com (M.A. Aghaei). Contents lists available at ScienceDirect International Journal of Pediatric Otorhinolaryngology journal homepage: http://www.ijporlonline.com/ http://dx.doi.org/10.1016/j.ijporl.2016.07.022 0165-5876/© 2016 Elsevier Ireland Ltd. All rights reserved. International Journal of Pediatric Otorhinolaryngology 89 (2016) 38e41