Abstract / Summary
Abstract Background This project’s objective was to compare the multidimensional recovery of adult patients who underwent tonsillectomies via bipolar or LigaSure diathermy using multiple outcome measures. Previous research has primarily examined the recovery of tonsillectomy patients through traditional pain scales. Methods A multiple-methods cohort study enrolled 150 adult patients ages 18–65 who underwent a tonsillectomy using bipolar (75 subjects) or LigaSure (75 subjects) diathermy. The study measured recovery based on composite pain and analgesia scores (CPAS), post-tonsillectomy hemorrhage severity (PTHS), tonsillar fossa healing index (TFHI), and duration for return to baseline level of function (RTB). Results The study demonstrated that patients undergoing surgery with bipolar diathermy had significantly shorter operating times (21.14 ± 4.20 minutes vs. 29.76 ± 5.10 minutes mean difference Δ = -8.62 minutes, 95% CI: -10.14 to -7.10; P = 0.000000000000000000000978). However, patients in the bipolar group experienced a secondary increase in pain at post-operative day (POD) 7 (mean CPAS 42.5 vs. 28.4; mean difference Δ = +14.10, 95% CI: +4.24 to + 23.96; P = 0.01) and also had a higher percentage of hemorrhages graded as grade 2 and grade 3 than patients undergoing tonsillectomy with LigaSure diathermy. Conclusion Although bipolar diathermy is associated with faster operative times, patients undergoing tonsillectomies with LigaSure diathermy experience a better overall recovery experience, with less secondary pain and bleeding, faster healing, and less severe hemorrhages.