Double-blind randomized controlled study of coblation tonsillotomy versus coblation tonsillectomy on postoperative pain in children.

摘要

OBJECTIVES: The purpose of this study was to establish if children experienced any difference in pain, between coblation tonsillectomy and coblation tonsillotomy. DESIGN: A double-blind randomized controlled trial was performed. SETTING: District general hospital department of Otolaryngology. PARTICIPANTS: Eighteen children listed for tonsillectomy were recruited into the study. Each was randomly assigned either tonsillotomy or tonsillectomy in the right tonsil. The contralateral tonsil was removed by the other method. In the first 24-h period (while in hospital) the children were interviewed at 2, 5, 10 and 24 h to quantify the pain they perceived in right and left sides. There was a four point visual analogue scoring system for monitoring pain. The power of the study was 80%. In this study the patients were their own controls. MAIN OUTCOME MEASURES: Visual analogue pain scores were plotted against time and the area under the curves was calculated (AUC). RESULTS: The AUC mean difference was 0.47. A t-test for the difference gives a P-value of 0.85 and a 95% confidence interval for difference is -0.79 to 5.73, which clearly contains zero. Using AUC as a combined pain score there is no statistically significant difference between tonsillotomy and tonsillectomy (power value of 80%). CONCLUSIONS: There is no demonstrable statistical difference between techniques when measuring pain experienced by children in the 24-h postoperative period.