BibTex RIS Kaynak Göster

Postoperative Evaluation of Pain After Tonsillectomy Wth Thermal Welding System

Yıl 2011, Sayı: 2, 75 - 79, 01.06.2011

Elif Ayanoğlu Aksoy Şenol Polat Gediz Murat Serin Ferhan Öz Asım Kaytaz

Öz

Objective: To compare postoperative pain in pediatric population after thermal welding system tonsillectomy and cold knife tonsillectomy prospectively. Patients and Methods: Forty-four children who had adenotonsillectomy under general anesthesia at two different hospitals of our institution’s ENT Clinics in January and February 2007 were included in the study groups prospectively. Wong Baker visual analogue pain scales were given to the patients at discharge. They were asked to note the pain scores every morning before taking analgesic drugs during the first seven days after surgery. Results: The mean length of surgery time in thermal welding system group was 29,17 minutes, while it was 45,95 minutes in cold knife tonsillectomy group. When the length of surgery in both groups were compared, there was a statistically significant difference p

Anahtar Kelimeler

thermal welding system cold knife tonsillectomy tonsillectomy pain

Kaynakça

  • Paradise JL, Bluestone CD, Bachman RZ, Colborn DK, Bernard BS, Taylor FH et al. Effi cacy of tonsillectomy for recurrent throat infection in severely aff ected children. N. Engl. J. Med. 1984;310: 674-83.
  • Curtin JM. The history of tonsil and adenoid surgery. Otolaryngol Clin North Am. 1987;20(2): 415-9.
  • Discolo CM, Darrow DH, Koltai PJ. Infectious indications for tonsillectomy. Pediatr Clin North Am. 2003 ; 50(2):445-58.
  • Parson SP, Cordes SR, Comer B. Comparison of posttonsillectomy pain using the ultrasonic scalpel, coblator and electrocautery. Otolaryngol. Head Neck Surg. 2006;134:106-13.
  • Faulconbridge RV, Fowler S, Horrocks J, Topham JH. Comparative audit of tonsillectomy. Clin. Otolaryngol. 2000; 25: 110-7.
  • Nunez DA, Provan J, Crawford M. Postoperative tonsillectomy pain in pediatric patients. Arch. Otolaryngol. Head Neck Surg. 2000;126:837—41.
  • Oko MO, Ganly I, Loughran S, Clement WA, Young D, Geddes NK. A prospective randomized single-blind trial comparing ultrasonic scalpel tonsillectomy with tonsillectomy by blunt dissection in a pediatric age group. Otolaryngol. Head Neck Surg. 2005;133: 579-84.
  • Skoulakis CE, Papadakis CE, Manios AG, Moshotzopoulos P, Theos E, Valagiannis DE. Tonsilloplasty in children with obstructive symptoms. J. Otolaryngol. 2007;36: 240-6.
  • Timms MS, Temple RH. Coblation tonsillectomy: a double blind randomized controlled study. J. Laryngol. Otol. 2002;116: 450-2.
  • Pang YT, El-Hakim H, Rothera MP. Bipolar diathermy tonsillectomy. Clin. Otolaryngol. 1994; 19: 335–57.
  • Saleh HA, Cain AJ, Mountain RE. Bipolar scissor tonsillectomy. Clin. Otolaryngol. 1999; 24: 9–12.
  • Back L, Paloheimo M, Ylikoski J. Traditional tonsillectomy compared with bipolar radiofrequency tonsillectomy in adults: a pilot study. Arch. Otolaryngol. Head Neck Surg. 2001; 127: 1106–12.
  • Sezen OS, Yasul EE, Kubilay U, Kaytanci H, Eken M, Unver S. Pediatrik hastalarda konvansiyonel soğuk bıçak tonsillektomi ile koblasyon tonsillektominin karşılaştırılması. KBB-Forum. 2006; 5(2).
  • Weingarten C. Ultrasonic tonsillectomy: rationale and technique. Otolaryngol. Head Neck Surg. 1997; 116: 193–6.
  • Martinez SA, Akin DP. Laser tonsillectomy and adenoidectomy. Otolaryngol. Clin. North. Am. 1987; 20: 371–6.
  • Linder A, Markstrom A, Hultcranz E. Using the carbon dioxide laser for tonsillectomy in children. Int. Pediatr. Otorhinolaryngol.1999; 50: 31–6.
  • BerglerW, Huber K, Hammerschmitt N et al. Tonsillectomy withargon plasma coagulation (APC): evaluation of pain and hemorrhage. Laryngoscope 2001;111: 1423–9.
  • Karatzias GT, Lachanas VA, Papouliakos SM, Sandris VG. Tonsillectomy using thermal welding system. ORL J. Otorhinolaryngol Relat. Spec. 2005; 67: 225–9.
  • Ozan SS, Kaytancı H, Kubilay U, Coşkuner T, Ünver Ş. Comparison between tonsillectomy with thermal welding and the conventional ‘cold’ tonsillectomy technique. ANZ J Surg. 2008;78:1014-8.
  • Chimona T, Proimos E, Mamoulakis C, Tzanakakis M, Skoulakis CE, Papadakis CE. Multiparametric comparison of cold knife tonsillectomy, radiofrequency excision and thermal welding tonsillectomy in children. Int J Pediatr Otorhinolaryngol.2008 Sep;72(9): 1431-6.
  • Chinpairoj S, Feldman MD, Saunders JC, Thaler ER. A electrosurgical system in a rat model. Laryngoscope 2001;111: 213-7.
  • Leinbach RF, Markwell SJ, Colliver JA, Lin SY. Hot versus cold tonsillectomy: a systematic review of the literature. Otolaryngol. Head Neck Surg. 129 (2003) 360-4.
  • Lee MS, Montague ML, Hussain SS. Post-tonsillectomy hemorrhage: cold versus hot dissection. Otolaryngol. Head Neck Surg. 131 (2004) 833-6.

Termal Welding Sistemi ile Tonsillektomi Sonrası Ağrı Değerlendirilmesi

Yıl 2011, Sayı: 2, 75 - 79, 01.06.2011

Elif Ayanoğlu Aksoy Şenol Polat Gediz Murat Serin Ferhan Öz Asım Kaytaz

Öz

Amaç: Prospektif olarak termal welding sistemi ve soğuk teknik diseksiyon ile tonsillektomi uygulanmış pediatrik olgularda postoperatif ağrının karşılaştırılması. Hastalar ve Yöntem: Bu çalışmaya prospektif olarak Ocak ve Şubat 2007’de kurumumuza bağlı KBB Kliniklerinde genel anestezi altında adenotonsillektomi uygulanmış 44 çocuk hasta dahil edilmiştir. Hastalar taburcu edilirken Wong Baker görsel ağrı değerlendirme skalası verilip 1 hafta boyunca her sabah uyanınca analjezik almadan önce ağrılarının şiddetini değerlendirmeleri istenmiştir. Bulgular: Termal welding sistemi TWS tonsillektomi grubunda cerrahi süresi ortalama 29,17 dakika, soğuk teknik ST tonsillektomi grubunda ise 45,95 dakika idi. Cerrahi süreleri kıyaslandığında iki grup arasında istatistiksel olarak anlamlı bir fark vardı. p < 0.01 . TWS grubunda kanama miktarı ortalama 19,5ml iken ST grubunda 123,9 ml idi. İstatistiksel olarak ST grubunda kanama miktarı anlamlı olarak daha fazla idi. p < 0.01 . TWS grubu ve ST grubu arasında ortalama ağrı skorları arasında istatistiksel olarak anlamlı bir fark gözlenmedi P > 0.05 . Sonuç: TWS pediatrik hasta grubunda klasik yönteme göre postoperatif ağrı bakımından anlamlı bir farklılık göstermemektedir. Ancak etkin, güvenilir, yeterli hemostaz sağlayan, cerrahi süreyi kısaltan bir yöntemdir.

Anahtar Kelimeler

termal welding sistemi soğuk teknik tonsillektomi tonsillektomi ağrı

Kaynakça

  • Paradise JL, Bluestone CD, Bachman RZ, Colborn DK, Bernard BS, Taylor FH et al. Effi cacy of tonsillectomy for recurrent throat infection in severely aff ected children. N. Engl. J. Med. 1984;310: 674-83.
  • Curtin JM. The history of tonsil and adenoid surgery. Otolaryngol Clin North Am. 1987;20(2): 415-9.
  • Discolo CM, Darrow DH, Koltai PJ. Infectious indications for tonsillectomy. Pediatr Clin North Am. 2003 ; 50(2):445-58.
  • Parson SP, Cordes SR, Comer B. Comparison of posttonsillectomy pain using the ultrasonic scalpel, coblator and electrocautery. Otolaryngol. Head Neck Surg. 2006;134:106-13.
  • Faulconbridge RV, Fowler S, Horrocks J, Topham JH. Comparative audit of tonsillectomy. Clin. Otolaryngol. 2000; 25: 110-7.
  • Nunez DA, Provan J, Crawford M. Postoperative tonsillectomy pain in pediatric patients. Arch. Otolaryngol. Head Neck Surg. 2000;126:837—41.
  • Oko MO, Ganly I, Loughran S, Clement WA, Young D, Geddes NK. A prospective randomized single-blind trial comparing ultrasonic scalpel tonsillectomy with tonsillectomy by blunt dissection in a pediatric age group. Otolaryngol. Head Neck Surg. 2005;133: 579-84.
  • Skoulakis CE, Papadakis CE, Manios AG, Moshotzopoulos P, Theos E, Valagiannis DE. Tonsilloplasty in children with obstructive symptoms. J. Otolaryngol. 2007;36: 240-6.
  • Timms MS, Temple RH. Coblation tonsillectomy: a double blind randomized controlled study. J. Laryngol. Otol. 2002;116: 450-2.
  • Pang YT, El-Hakim H, Rothera MP. Bipolar diathermy tonsillectomy. Clin. Otolaryngol. 1994; 19: 335–57.
  • Saleh HA, Cain AJ, Mountain RE. Bipolar scissor tonsillectomy. Clin. Otolaryngol. 1999; 24: 9–12.
  • Back L, Paloheimo M, Ylikoski J. Traditional tonsillectomy compared with bipolar radiofrequency tonsillectomy in adults: a pilot study. Arch. Otolaryngol. Head Neck Surg. 2001; 127: 1106–12.
  • Sezen OS, Yasul EE, Kubilay U, Kaytanci H, Eken M, Unver S. Pediatrik hastalarda konvansiyonel soğuk bıçak tonsillektomi ile koblasyon tonsillektominin karşılaştırılması. KBB-Forum. 2006; 5(2).
  • Weingarten C. Ultrasonic tonsillectomy: rationale and technique. Otolaryngol. Head Neck Surg. 1997; 116: 193–6.
  • Martinez SA, Akin DP. Laser tonsillectomy and adenoidectomy. Otolaryngol. Clin. North. Am. 1987; 20: 371–6.
  • Linder A, Markstrom A, Hultcranz E. Using the carbon dioxide laser for tonsillectomy in children. Int. Pediatr. Otorhinolaryngol.1999; 50: 31–6.
  • BerglerW, Huber K, Hammerschmitt N et al. Tonsillectomy withargon plasma coagulation (APC): evaluation of pain and hemorrhage. Laryngoscope 2001;111: 1423–9.
  • Karatzias GT, Lachanas VA, Papouliakos SM, Sandris VG. Tonsillectomy using thermal welding system. ORL J. Otorhinolaryngol Relat. Spec. 2005; 67: 225–9.
  • Ozan SS, Kaytancı H, Kubilay U, Coşkuner T, Ünver Ş. Comparison between tonsillectomy with thermal welding and the conventional ‘cold’ tonsillectomy technique. ANZ J Surg. 2008;78:1014-8.
  • Chimona T, Proimos E, Mamoulakis C, Tzanakakis M, Skoulakis CE, Papadakis CE. Multiparametric comparison of cold knife tonsillectomy, radiofrequency excision and thermal welding tonsillectomy in children. Int J Pediatr Otorhinolaryngol.2008 Sep;72(9): 1431-6.
  • Chinpairoj S, Feldman MD, Saunders JC, Thaler ER. A electrosurgical system in a rat model. Laryngoscope 2001;111: 213-7.
  • Leinbach RF, Markwell SJ, Colliver JA, Lin SY. Hot versus cold tonsillectomy: a systematic review of the literature. Otolaryngol. Head Neck Surg. 129 (2003) 360-4.
  • Lee MS, Montague ML, Hussain SS. Post-tonsillectomy hemorrhage: cold versus hot dissection. Otolaryngol. Head Neck Surg. 131 (2004) 833-6.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Elif Ayanoğlu Aksoy

Şenol Polat

Gediz Murat Serin

Ferhan Öz

Asım Kaytaz

Yayımlanma Tarihi 1 Haziran 2011
Yayımlandığı Sayı Yıl 2011Sayı: 2

Kaynak Göster

EndNote Aksoy EA, Polat Ş, Serin GM, Öz F, Kaytaz A (01 Haziran 2011) Termal Welding Sistemi ile Tonsillektomi Sonrası Ağrı Değerlendirilmesi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2 75–79.