Abstract
Objective: Recently, the use of low temperature pulsed radiofrequency (RF) energy has emerged as a method for efficient tissue dissection with minimal thermal damage. When used for tonsillectomy, anecdotal reports have cited improved recovery compared with traditional electrosurgery (ie, Bovie). We evaluated this technology in adults undergoing subcapsular tonsillectomy.
Method: Twenty adults were prospectively enrolled in this pilot study. Subjects were randomized to tonsillectomy with the PlasmaBlade (PB) or traditional electrosurgery (ES). Intra-operative time and blood loss were recorded; postoperatively, subjects blindly reported visual analog scale painscores, narcotic consumption, diet volume, and activity level using a validated form.
Results: The population age (34.7 ± 18.7 years, P = .75) and BMI (24.7 ± 3.9 kg/m2, P = .44) were equivalent. Operative time was also equivalent for both technologies (7:36 ± 1:58 min, P = .99) with PB subjects demonstrating a 69% reduction in IBL (1.6 ± 1.8 vs 5.3 ± 7.9mL, P = .02) compared with ES. Postoperatively, PB subjects demonstrated a 40% (2.5 ± 1.2 vs 4.1 ± 0.7 Tylenol-Codeine/d, P = .002) reduction in narcotic consumption over the 10-day monitoring period. Modest improvements in activity level (6%; P = .83), diet volume (20%, P = .32), and VAS pain score (12%, P = .41) were also reported. However, these were not statistically significant.
Conclusion: The use of this new low-thermal damage electrosurgical technology for adult tonsillectomy appears to offer several advantages over traditional electrosurgery, notably in reducing narcotic consumption in the postoperative period. Larger population-based studies should be conducted to further examine these endpoints.
Get full access to this article
View all access options for this article.