Coblation Reduced Post-operative Pain Over Bipolar Diathermy in Tonsillectomy Operation

Subrata Ghosh ^1*, Milon Kumar Haldar ¹, Abu Hena Mostafa Kamal ²

This study determined superior clinical outcomes of Coblation over Bipolar Diathermy in tonsillectomy, promoting evidence-based otolaryngologic practices in Bangladesh.

Abstract

Background: Tonsillectomy is a common surgical procedure performed for conditions like chronic tonsillitis and obstructive sleep apnea. Coblation and Bipolar Diathermy are advanced techniques that offer potential benefits over traditional methods; however, comparative studies evaluating these techniques in Bangladesh are scarce. Methods: A prospective analysis of 750 tonsillectomy cases (420 Coblation, 330 Bipolar Diathermy) was conducted at the Department of ENT, Rajshahi Medical College Hospital and Metropolitan Hospital, Rajshahi, Bangladesh, from January 2021 to June 2024. Data were collected on primary outcomes (pain duration, post-operative bleeding rates, healing time) and secondary outcomes (operation time, analgesic use, intra-operative bleeding, diet, and healing degree). Statistical analysis included chi-square and t-tests. Results: Coblation tonsillectomy significantly reduced post-operative pain duration compared to Bipolar Diathermy. In the pediatric group (ages 3-15 years), 85% of Coblation patients reported pain resolution within 5-7 days, while only 60% in the Bipolar group achieved resolution within 8-12 days. In adults (>15 years), 70% experienced pain resolution within 8-10 days with Coblation versus 55% with Bipolar Diathermy. Coblation was associated with lower reactionary hemorrhage rates (pediatric: 0.24% vs. 1.21%; adult: 0.1% vs. 0.61%) and secondary hemorrhage rates (pediatric: 1.67% vs. 3.33%; adult: 2.17% vs. 3.57%). Healing times were shorter with Coblation, with reduced analgesic use, lower intra-operative bleeding (average 1.5 ml vs. 3.5 ml), earlier return to a normal diet, and faster healing in the tonsillar fossa. Conclusion: Coblation tonsillectomy provides superior outcomes in terms of pain management, bleeding complications, and healing time compared to Bipolar Diathermy. These findings support Coblation as a preferred tonsillectomy technique for both pediatric and adult patients in a tertiary care setting in Bangladesh.

Keywords: Coblation, Bipolar Diathermy, Tonsillectomy, Bleeding Complications, Healing Time, Postoperative outcomes, Pain management

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