Author(s)
W. O. Collins
K. Mathias
C. O. Dirain
R. Silva
Affiliation(s)
University Of Florida
Abstract:
INTRODUCTION: Poor pain control following adenotonsillectomy (T&A) may lead to delayed discharge, dehydration and readmission. The use of radiofrequency ablation purportedly reduces postoperative pain, but results in higher equipment costs. This expense could potentially be recouped if reduced pain leads to earlier hospital discharge. OBJECTIVE: The current pilot study aimed to compare the discharge times following inpatient T&A using monopolar electrocautery (MEC) vs. radiofrequency ablation (RFA). METHODS: IRB-approved, prospective non-randomized study of children undergoing inpatient T&A with MEC vs. RFA (Coblator™). The main outcome measures were the total hospital length of stay (LOS) and variance to a goal of discharge before 8 AM on postoperative day #1. Demographic data, surgical indications, technique, postoperative complications were also collected. RESULTS: Twenty eight children, ages 2-8 years of age, were enrolled (14 females and 14 males). The surgical indications included obstructive sleep apnea in 27 patients, and recurrent pharyngotonsillitis in one patient. The mean LOS in the RFA was lower than the MEC group (19.6 vs 22.4 hours). The RFA group also had a decreased mean discharge time variance compared to the MEC group (139.5 vs 15.6 min, p = 0.13). One primary postoperative hemorrhage occurred in the RFA group, and 1 clinically significant desaturation in the MEC group. DISCUSSION: In this small sample of patients, there was a significantly earlier discharge times in children undergoing T&A with RFA as compared to MEC. Further cost analysis in a larger sample would determine potential cost benefits to the institution.