Hemostasis during Cold Dissection Tonsillectomy: Comparing the Use of Adrenaline and Normal Saline

Abstract

Various hemostatic agents and techniques have been used to reduce intraoperative and postoperative hemorrhage in tonsillectomy. This study aims to compare the effect of using adrenaline and normal saline in maintaining hemostasis during cold dissection tonsillectomy. This is a prospective randomized single-blind study spanning fifty seven months in a private hospital setting in Jos, Plateau State, Nigeria. Thirty seven patients aged between 2 and 31 years had tonsillectomy consisting of 22 (59.5%) males and 15 (40.5%) females. The mean age of patients was 15.6 years (SD= ± 8.97). Recurrent tonsillitis (45.9%) was the commonest indication for surgery and obstructive sleep apnea was the commonest associated indication in 12 (32.4%) patients. In 12 (32.4%) patients, there was no associated indication for surgery. The mean time required to achieve hemostasis with the use of adrenaline soaked gauze compress was 3.84 min. (SD= ± 0.92) and with the normal saline soaked gauze compress was 4.15 min. (SD=± 0.81) with a difference of 0.31 min. There was no incidence of primary, reactionary or secondary hemorrhage. The local application of adrenaline as a topical hemostatic agent during tonsillectomies is effective in reducing intraoperative and postoperative hemorrhage and invariably reducing operative time with no significant side effects or complications.