缝合腭弓对扁桃体术后出血影响的临床研究

目的 客观评价缝合腭弓在减少扁桃体术后出血中的作用.方法 回顾性分析2013年1月至2019年10月行成人扁桃体切除术患者234例,所有患者均在全麻下行低温等离子扁桃体切除术,其中125例患者为预防术后出血行双侧腭弓缝合(观察组),另109例患者未行腭弓缝合(对照组),观察与记录术后出血情况.结果 观察组和对照组原发性...     

52例扁桃体术后出血诊治疗效观察

目的探讨扁桃体切除术后出血的多种止血措施疗效,为临床实践提供指导。方法回顾性分析52例等离子扁桃体切除术后出血患者的临床资料,采用双氧水棉球局部压迫、利多卡因稀释液局部肌注间接压迫、双极电凝固、缝合结扎四种处理方式,观察24小时内止血治疗效果。结果本研究中52例患者共计发生出血70次;止血操作成功事件中,双氧水棉球压迫占28例(28/36,77.78%)、利多卡因液肌注压迫5例(5/7,71.43%)、双极电凝固19例(19/19,100%)、缝合结扎8例(8/8,100%),与双氧水棉球压迫、利多卡因液肌注压迫相比,双极电凝固与缝合结扎两种方式的止血成功率显著更高(χ^2=7.355,P=0.037)。结论扁桃体切除术后出血是一常见并发症,采用双极电凝固法或缝合结扎法可以有效的彻底止血。     

Significantly reducing post-tonsillectomy hemorrhage requiring surgery by double-layer suture: A retrospective analysis

BackgroundAlthough tonsillectomies carry a low-risk for adverse events, postoperative hemorrhage has been reported as the most common complication.AimTo compare the rates of postoperative secondary hemorrhage for tonsillectomy with or without double-layer suture.Material and methodsThis is a retrospective study of 5087 patients who underwent coblation tonsillectomy with or without suture from 2006 to 2016. All cases had been followed up 3 weeks and severe secondary hemorrhage cases requiring operation were analyzed.ResultsThe severe secondary hemorrhage rate was statistically higher in group without suture (1.96%) as compared with the group with suture (1.08%). The surgery time (36.55 ± 7.45) was longer in patients with suture as compared to patients without suture (31.50 ± 6.23). In the age between 18 and 49 years group, the higher secondary hemorrhage rate (2.44%) was found in patients without suture. The rate of postoperative hemorrhage (0.96%) was significantly higher in patients without suture as compared with patients with suture (0.36%) on postoperative 5th day.ConclusionsThe risk of severe secondary hemorrhage is reduced in coblation tonsillectomy with suture. The rate of secondary hemorrhage is lower in patients with suture in 18 to 49 years old group and on the 5th day after surgery.     

Nasal septum suture combined with inferior turbinate coblation after septoplasty: Does it improve quality of life and reduce complications?

ObjectiveNasal packing is routinely applied after septoplasty. Patients, however, report feeling very uncomfortable while the packing is in place. The aim of this study was to compare the effects of nasal septum suture combined with inferior turbinate coblation to the effects of nasal packing after septoplasty.MethodsIn this study, 135 patients undergoing septoplasty were divided into 3 groups: group 1 patients had microdebrider with packing, group 2 received coblation with packing and group 3 had coblation with suture. Early postoperative quality of life and complications were compared between the 3 groups.ResultsThe patients in group 1 experienced the most postoperative nasal pain, headache, dysphagia, sleep disturbance and bleeding on the night of surgery; while the patients in group 3 experienced the fewest symptoms. No difference in epiphora was observed between the 3 groups. More pain and bleeding were experienced when comparing the pack removal (Group 1 and 2) with the clearance of the nasal cavity (Group 3). We noted one case of postoperative bleeding in group 1, one septal hematoma in group 1 and a second septal hematoma in group 2. No such postoperative complications were found in group 3.ConclusionNasal septum suture combined with inferior turbinate coblation was not only associated with less pain, increased patient satisfaction and an improved quality of life; but also reduced postoperative complications. Our results confirm that it is a more comfortable, reliable alternative to the more common nasal packing.     

Nasal packing and transseptal suturing techniques: surgical and anaesthetic perspectives

The objective of this study is to compare the nasal packing and the transseptal suturing techniques regarding the extubation difficulty evaluation scores, follow-up times in post-anaesthesia care unit (PACU), pain scores, and postoperative complications. Two hundred patients who underwent septoplasty from January 2009 to October 2009 were randomly assigned either to have nasal packs (n: 100) or transeptal sutures (n: 100). In the transseptal suture group, extubation was easier and PACU follow-up times were shorter, when compared to the nasal packing group (p < 0.001). Patients with nasal packing had significantly higher pain scores (p < 0.001). Minor bleeding was significantly higher in the transseptal group with seven cases, compared to the nasal packing group without any bleeding cases (p = 0.014). There were two patients who had postoperative major bleeding, and two patients who had septal hematoma in the transseptal suture group. One patient with nasal packing had postoperative infection. Septal perforation was not seen in any of the cases. While patients in both groups experienced postoperative crusting, patients in the transseptal suture group also complained about foreign body sensation. Extubation was more comfortable; post-anaesthesia monitorization duration was shorter, and postoperative pain was less, but minor bleeding was seen more with transseptal sutures. There was no significant difference in terms of major bleeding, hematoma, infection or perforation. Foreign body sensation was the main cause of postoperative discomfort in the transseptal suture group. Transseptal suturing might be a significantly comfortable, cost-effective and reliable alternative to nasal packing.     

Vessel sealing system uvulopalatoplasty versus uvulopalatal flap: a randomized, controlled study of efficacy and adverse effects

The objective of this randomized, controlled study is to compare intraoperative blood loss, operative time, postoperative pain and postoperative adverse effects (bleeding, velopharyngeal insufficiency and others) between vessel sealing system uvulopalatoplasty (VSSU) and uvulopalatal flap (UPF). The study was conducted at the Department of Otolaryngology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. 31 subjects with sleep-disordered breathing and obstruction at the retropalatal level were enrolled consecutively. Intervention was randomized by mixed block randomization into 2 groups (UPF, VSSU). Stratification was also done by the presence or absence of concomitant tonsillectomy. Measured outcomes, which were blinded to patients and outcome assessor, were intraoperative blood loss, operative time, postoperative pain, postoperative bleeding, postoperative velopharyngeal insufficiency and other adverse effects. Median (IQR) of intraoperative blood loss from VSSU and UPF was 0.00 (0.00–1.00) and 6.00 (1.25–12.75) ml (p < 0.001). Median (IQR) of operative time from VSSU and UPF  was  3.50 (3.00–5.00) and 15.00 (12.25–18.00) min (p < 0.001). There was significantly less pain in VSSU group on operative day (p = 0.001) and postoperative day 1 (p = 0.009). However, no significant difference of pain on postoperative day 2 to day 14 (p = 0.055–0.983) between both groups. Regarding postoperative bleeding, 1 case of immediate bleeding in UPF group and 1 case of delayed bleeding in VSSU group were found in this study. Postoperative velopharyngeal insufficiency and other adverse effects were not found in both groups. In conclusion, VSSU was better than UPF in terms of less intraoperative blood loss, less operative time and less pain in early postoperative period. Postoperative velopharyngeal insufficiency and other adverse effects were not found in both groups.     

Tonsillektomie mit Koagulationsschere oder Raspatorium

Background

Postoperative bleeding is the major complication in tonsillectomy, and pain the most common side effect. The use of bipolar scissors versus blunt dissection tonsillectomy were compared in this study in order to evaluate postoperative bleeding and pain, as well as operative time.

Methods

In this case control study, 138 patients with the diagnosis of chronic tonsillitis, mononucleosis or a peritonsillar abscess were divided into two groups. A total of 78 patients were operated using bipolar scissors while 60 patients underwent tonsillectomy by blunt dissection. Operating time, frequency of postoperative bleeding and the postoperative pain score were compared between these two groups.

Results

The average operating time in the bipolar scissor group showed a tendency to be shorter than in the blunt dissection group (mean 4.1 min), although this did not reach a level of statistical significance. No differences were seen in pain scores or in the incidence of postoperative bleeding.

Conclusion

The data documented in this study show that tonsillectomy with bipolar scissors might represent a surgical option to reduce surgical time in a larger patient group. Postoperative pain and the incidence of postoperative bleeding did not show any statistical difference between the two surgical techniques.     

The effectiveness of low-level laser on postoperative pain and edema in secondary palatal operation

ObjectiveThe postoperative period after palatal surgery is usually very painful, requiring the use of pain-relieving drugs. Hence, the aim of this study was to evaluate the efficacy of Low-level laser therapy (LLLT) in post-operative pain control and edema after secondary palatal operations.MethodsA randomized double blinded clinical study on 20 children undergoing secondary palatal operations between 2013 and 2015 was done. Patients were randomly divided on two groups 10 patients each. In one group patients received local application of therapeutic laser immediately after surgery while patients received nothing in the control group. The mean age was 5.22 years ± 2.53 SD in the laser group and 6.42 years ± 0.76 in the control group. Postoperative pain was assessed by using visual analog scale scores and by recording the need of analgesics. The degree of postoperative edema was also recorded.ResultsThe pain scale showed significantly less postoperative pain in the laser group than in the control group from the first day (P-value = 0.006) to the 6th day (P-value = 0.014). The number of postoperative analgesic doses needed were significantly less in the laser group in the second and third days (P-value = 0.014). The postoperative edema was significantly higher in the control group from the 2nd (P-value = 0.004) to the 7th (P-value = 0.014) postoperative days.ConclusionsPreliminary results showed that low-level laser therapy is effective in the reduction of postoperative pain and edema, and minimizing the need of analgesic medication after secondary palatal operations.     

Blunt dissection versus electronic molecular resonance bipolar dissection for tonsillectomy: operative time and intraoperative and postoperative bleeding and pain

OBJECTIVE: To compare operative time, intraoperative and postoperative bleeding and pain using two different techniques for tonsillectomy: electronic molecular resonance bipolar tonsillectomy and blunt dissection tonsillectomy. METHODS: From January 2005 to December 2006, a prospective, randomised study was performed in 800 children, aged from 3 to 10 years, admitted to the ENT (Ear Nose Throat) Unit of Giannina Gaslini Institute, Genoa, Italy to undergo tonsillectomy. Patients were randomised into two surgical groups, Group A (electronic molecular resonance tonsillectomy, EMRBT) and Group B (blunt dissection tonsillectomy). Operative time, intraoperative blood loss and postoperative complications were recorded. During 10 days after surgery, children and their parents were also asked to provide a rating of the patients' current pain intensity using a visual analogue scale. In this period, the parents were also asked to note the analgesic drugs administered. RESULTS: Duration of surgery and blood loss were significantly much lower in the group undergoing electronic molecular resonance bipolar tonsillectomy (p<0.0001). Postoperative pain scores resulted significantly different between the two methods on days 5 (p=0.05) and 8 (p=0.001) in evaluations by mothers. Moreover, in evaluations by patients pain scores resulted significantly different between the two methods on days 3 (p=0.02), 8 (p=0.005) and 9 (p=0.01). We found no difference between boys and girls in pain scores in the 10 days considered, nor between children older than 5 yrs and children younger than or aged 5 years. No statistically significant differences between the two techniques were found in the use of analgesics in all postoperative evaluations. CONCLUSIONS: This study showed that the use of electronic molecular resonance bipolar tonsillectomy, compared to blunt dissection, has several advantages. Reduced operative time and intraoperative bleeding make EMRBT more cost effective and allow an increased number of operations. Concerning postoperative pain, the two techniques did not present significant differences in the use of analgesics. The number of postoperative bleeding episodes was also similar in the two groups of patients.     

甲泼尼龙对扁桃体等离子切除术后并发症的影响

目的　评估静脉输注甲泼尼龙对扁桃体等离子切除术后恢复及术后并发症的影响。方法　观察2015年12月～2016年12月份于我科行双扁桃体等离子切除术的83例患者,采用随机、双盲的原则将低龄、高龄两组观察对象分别分为实验组及对照组,实验组术后静点甲泼尼龙观察患者术后反应,如疼痛程度、活动量、咽部水肿、身体情况、白膜脱落时间、继发性出血等多项指标。结果  ①术后3～5天,甲泼尼龙可减轻低龄组疼痛感（Z =4.42,P =0.00）,增加患者活动量（Z =2.64,P =0.00）、减轻咽部水肿（Z =2.84、3.10,P 均=0.00）。②术后身体情况低龄实验组消化道不适发生率低于对照组（χ2=4.97,P =0.03）;高龄实验组消化道不适（χ2=5.24,P =0.02）、睡眠障碍（χ2=5.03,P =0.03）发生率均低于对照组。③白膜脱落情况在高龄实验组白膜脱落时间晚于对照组（t =2.16,P =0.04）。④继发性出血两组之间无明显差异（χ2=1.29,P =0.26）。结论　扁桃体等离子切除术后静点甲泼尼龙在缓解疼痛、消化道不适、减轻水肿及延迟白膜脱落方面有效。     

儿童扁桃体、腺样体低温等离子切除术后出血的临床研究

目的 探讨应用低温等离子手术或者传统手术方式行儿童扁桃体、腺样体切除术在术后出血方面存在的差异。方法 回顾性分析1597例接受手术治疗的儿童慢性扁桃体炎、腺样体肥大的患者资料,行等离子射频辅助的扁桃体和(或)腺样体切除术者793例(等离子组),行传统扁桃体切除和(或)腺样体者804例(传统组)。比较两组原发性及继发性出血的发生率、出血程度和出血部位的差异。结果 等离子组发生术后出血25例(3.2％),传统组出血19例(2.4％),两组间差异无统计学意义(χ2=3．34,P>0．05);其中等离子组原发性出血9例(1.1％),继发性出血16例(2.0％);传统组原发性出血11例(1.4％),继发性出血8例(1．0％),两者比较差异有统计学意义(χ2=9．45,P<0．01)。两组术后的出血部位经卡方检验,出血程度经Wilcoxon秩和检验,P值均>0．05,差异均无统计学意义。结论 低温等离子辅助行儿童扁桃体、腺样体切除术,在术后出血的发生率、程度、部位三个方面相对于传统的手术方法治疗,二者差异无统计学意义。     

Tonsillektomie in Hydrodissektionstechnik

BACKGROUND.: Tonsillectomy is one of the most common procedures in head and neck surgery. Various techniques have been developed to reduce the risk of postoperative bleeding and postoperative pain. Water-jet technology has been designed for a gentle dissection of parenchymal organs. We report the results of a first pilot study using the water-jet technique for tonsillectomy.METHODS.: Water-jet-cutting tonsillectomy was compared with conventional blunt dissection tonsillectomy. 60 Patients were stratified in two groups within a preliminary prospective randomised study. Postoperative pain scores, frequency of postoperative bleeding and intraoperative blood loss were documented.RESULTS.: There was no difference in the average duration of the surgical procedure. The intraoperative bloodloss was markedly decreased in water-jet-cutting tonsillectomy. Postoperative bleeding and postoperative pain were decreased in the water-jet-cutting group.CONCLUSION.: The results of this pilot study demonstrate that water-cutting tonsillectomy is associated with less intraoperative bleeding, reduced frequency of postoperative bleeding events and with less postoperative pain.     

改良鼻中隔缝合联合等离子下鼻甲消融在鼻中隔偏曲矫正术中的选择性应用

目的 鼻中隔偏曲矫正术后使用改良鼻中隔缝合技术,等离子消融下鼻甲,术后不填塞鼻腔,比较其与传统方法的疗效.方法 80例行鼻中隔偏曲矫正术患者分为填塞组和缝合组,行鼻中隔矫正术后,填塞组吸切钻切削下鼻甲后行鼻腔填塞,缝合组行改良鼻中隔缝合、等离子消融下鼻甲,无填塞.比较两组患者术后症状、体征评分.结果 填塞组在手术后鼻部...     

Can mucosal sealing reduce tonsillectomy pain?

OBJECTIVE/HYPOTHESIS: The hypothesis tests whether sealing the tonsillectomy field with posterior pillar mucosa can prevent unwanted outcomes in pediatric tonsillectomy. STUDY DESIGN: A prospective, randomized, single blinded study was conducted on a sample of 39 children between 3 and 15 years of age. After dissection and snare tonsillectomy, the tonsillar fossa was covered on one side using the palatopharyngus mucosa and the other side is used as control. Pain scores, healing, edema and infection at the operation site were investigated. METHODS: The tonsillectomy sites were randomly assigned into one of two groups. First group contained the ones with mucosal flap sealed over the operation site and the second group was kept as control with the operation site left uncovered. All of the patients received mild analgesics. The pain assessment is done on Days 1, 3, 5, 7 and 10 postoperatively, by using Wong-Baker faces visual analog scale. On the 10th postoperative day, the operation field of each side is scored separately for edema, healing and infection. Statistical investigation was performed through a software program. RESULTS: On first postoperative day, pain level difference was not statistically significant between the two groups (p>0.01). But from 3rd to 10th postoperative day, the pain level was found out to be lower in the mucosa sealed site (p<0.01). On the 10th postoperative day, while the edema was significantly more (p<0.01), healing was better (p<0.01) at the sutured site. Postoperative infection at operation site was not different between the groups (p>0.01). CONCLUSION: Covering tonsillectomy field with mucosal palatopharyngeal arch flap significantly reduces pain after third postoperative day. The flap side had better healing when compared to denuded site. But the sutures in the mucosal flap may cause more tissue edema. Sutures have no significant effect on postoperative infection. Thus, mucosal flap may be used as an adjuvant surgical technique to decrease tonsillectomy pain of children in addition to the analgesic medication.     

Postoperative pain and side effects after uvulopalatopharyngoplasty, laser-assisted uvulopalatoplasty, and radiofrequency tissue volume reduction in primary snoring

OBJECTIVES: We compared, in a prospective study, the side effects and the postoperative complications of three procedures commonly used for the treatment of primary snoring. METHOD: Forty-nine patients underwent velopharyngeal surgery for primary snoring (17 for uvulopalatopharyngoplasty [UPPP]; 15 for laser-assisted uvulopalatoplasty [LAUP], and 17 for radiofrequency tissue volume reduction [RFTVR]). Preoperative full polysomnographic studies ruled out obstructive sleep apnea syndrome. Each patient's evaluation encompassed postoperative pharyngeal pain (as measured by a 5-point visual analogue scale) and use of narcotic drugs in the early postoperative period as well as a subjective evaluation of late postoperative complaints. A surgeon's examination was performed to report postoperative complications in the oropharynx. RESULTS: Postoperative pharyngeal pain was less important in the RFTVR group than in the UPPP and LAUP groups. Mean scores at days 3, 7, 16 were as follows: 4.2, 4.0, and 2.4, respectively, for UPPP; 4.6, 3.8, and 1.6 for LAUP; and 2.4, 2.0, and 0.7 for RFTVR. Mean duration of pain with a score greater than 2 was calculated as follows: UPPP, 21.3 days; LAUP, 15.1 days; and RFTVR, 6.1 days. Mean duration of narcotic drug use for the patients who needed this medication was 10.1 days for UPPP, 7.2 days for LAUP, and 1.3 for RFTVR. Postoperative side effects (trouble with smell and taste, pharyngeal dryness, globus sensation, voice change, and pharyngonasal reflux) were more present in the UPPP and LAUP groups than in the RFTVR group. Surgeon's assessment for postoperative complications reported more wound infection, dehiscence, and posterior pillar narrowing in the UPPP and LAUP groups than in the RFTVR group. CONCLUSION: RFTVR is a safer and less painful procedure than UPPP and LAUP for the treatment of primary snoring. Postoperative discomfort after LAUP and after UPPP appears to be very similar.     

低温等离子刀、超声刀及传统方式行扁桃体切除术的比较

目的 探讨运用低温等离子刀、超声刀及传统手术方式行扁桃体切除术的优、缺点,并对三种术式特点和应用价值进行评价。 方法 需行扁桃体切除术的患者117例,分为低温等离子刀组、超声刀组及传统组,每组各39例,记录双侧扁桃体切除术的手术时间和术中出血量、术后咽部疼痛、术后原发性及继发性出血等。 结果 等离子刀组、超声刀组的手术时间及术中出血量均较传统组降低,差异有统计学意义(P<0.05);等离子刀组手术时间 ［(9.92±4.04)min］较超声刀组手术时间［(15.86±1.36)min］短,差异有统计学意义(P<0.05),两组术中出血量差异无统计学意义(P>0.05)。等离子刀组、超声刀组分别与传统组在术后前3天的疼痛评分差异均有统计学意义(P<0.05),此后三组疼痛评分差异无统计学意义(P>0.05);等离子刀组较超声刀组术后疼痛轻,但是两者疼痛评分差异无统计学意义。等离子刀组与传统组各出现1例术后原发性出血的病例。等离子刀组1例、超声刀组1例、传统组2例出现继发性出血。三组伪膜开始脱落时间差异无统计学意义(P>0.05)。三组术后24 h咽部水肿评分差异有统计学意义(P<0.05),等离子刀组及超声刀组咽部水肿轻于传统组,但等离子刀组与传统组咽部水肿差异无统计学意义(P>0.05)。 结论 低温等离子刀切除扁桃体是较为安全、有效的手术方法,但其费用相对较高。对于慢性扁桃体炎病程长且瘢痕粘连较重的患者,建议选用超声刀切除扁桃体。     

Tonsillektomie mit dem ultraschallaktivierten Skalpell Erste Ergebnisse zur Technik mit dem Ultracision Harmonic Scalpel®

BACKGROUND: Tonsillectomy requires an efficient intra- and postoperative hemostasis. The ultrasonically activated scalpel (UAS) uses high-frequency ultrasonic energy to perform tissue dissection and coagulation simultaneously. The present prospective study represents the first published results of UAS in tonsillectomy. METHOD: 60 patients with tonsillectomy were examined in regard of intra- and postoperative hemostasis, wound healing and postoperative pain. Also, the quality of the histopathological specimen was evaluated. RESULTS: In 90% of tonsillectomies by UAS efficient intraoperative hemostasis did not require suture ligature. In 10% additional ligation was required for reason of arterial bleeding. Postoperative bleeding did not occur at all, wound healing was uneventful. Surgery related postoperative pain was not intensified. The histopathological evaluation of specimen was not impaired. CONCLUSION: The UAS offers a tissue dissection with efficacious intra- and postoperative hemostasis. Compared to the conventional tonsillectomy the ultrasonical technique of tonsillectomy has especially in children, in anaemic patients and in the surgery of tonsillar malignomas significant advantages.     

Teenage and adult tonsillectomy: dose-response relationship between diathermy energy used and morbidity.

OBJECTIVE: To determine whether an increase in the use of bipolar diathermy energy to perform a tonsillectomy is associated with an increase in postoperative pain and haemorrhage. STUDY DESIGN: Prospective study. SETTING: District General Hospital. METHODS: In all, 101 patients above the age of 13 years who underwent a tonsillectomy that involved the use of bipolar diathermy during the study period were included. The cumulative amount of diathermy energy used to perform each tonsillectomy was calculated with the help of a digital stop clock timing device connected to the diathermy foot-pedal. MAIN OUTCOME MEASURES: Postoperative pain scores and the incidence of secondary haemorrhage were recorded for each patient at four points in time following surgery, up to the tenth postoperative day. The haemorrhage rates were categorised into three groups (no bleeding, minor bleeding and major bleeding) according to severity. Associations between the diathermy energy used to perform each tonsillectomy and the corresponding postoperative pain scores and secondary bleeding rates were investigated. RESULTS: There was a statistically significant positive relationship between the total amount of bipolar diathermy energy used per tonsillectomy and the pain scores at all the four recorded points in time (r(s) = 0.44-0.72, P < 0.001). When the median energy consumption in the three groups (no bleeding, minor bleeding and major bleeding) were compared using the Kruskal-Wallis test, we found that there was limited evidence of a difference between the groups, but this was not statistically significant at the 5% level [H (2) = 5.374, P = 0.065, 99% CI 0.058-0.071]. CONCLUSIONS: Increased use of bipolar diathermy during the performance of a tonsillectomy is associated with a statistically significant increased amount of postoperative pain. The dose-response relationship between diathermy energy and postoperative bleeding is less clear. This suggests that there could be other important factors such as surgical instrument characteristics and degree of tonsillar adherence that have an additional influence and are therefore possible areas for future research.     

Profilaxis antibiótica en amigdalectomías y su relación con la morbilidad postoperatoria

Introduction and objectivesPostoperative pain is the main symptom and the most incapacitating one in tonsillectomy, and prescribing oral antibiotics to reduce postoperative pain is common. The objective of this study was to evaluate the efficacy of 2 different prophylactic antibiotic schemes to reduce postoperative morbidity in paediatric patients undergoing tonsillectomy. One scheme consisted of a single-dose preoperative cephalothin, while the second was an oral antibiotic.MethodsThis was an open randomized trial on patients aged 4-15 years undergoing tonsillectomy. The experimental group received single-dose intravenous cephalothin, while the control group received single-dose intravenous cephalothin plus oral suspension of amoxicillin/clavulanate for 7 days. We compared the presence and intensity of pain, limitations to normal diet, habitual activities, halitosis, otalgia and nausea within 7 days after surgery using the Wong-Baker FACES Pain Scale and a questionnaire for the parents.ResultsFor the 102 patients that underwent tonsillectomy (51 per group), there was no difference in the presence and severity of postoperative pain between the 2 groups (P>.05). Neither was there any difference in the days needed to return to normal activities, normal diet, and duration of days with halitosis, otalgia or nausea. Just 1 patient from the control group had postoperative bleeding. There were no infectious complications.ConclusionsThe use of single-dose preoperative intravenous cephalothin has the same efficacy as the use of oral amoxicillin/clavulanate for 7 days in reducing morbidity in paediatric patients undergoing tonsillectomy and offers safe antimicrobial prophylaxis. Consequently, the routine use of oral antibiotics should be avoided.