Fever rates elevated after powered intracapsular tonsillectomy, adenoidectomy

Powered intracapsular tonsillectomy and adenoidectomy (PITA) is associated with higher rates of fever one week postoperatively compared with cold adenotonsillectomy in children, according to a study published online Dec. 30 in Clinical Otolaryngology.

Roee Noy, M.D., from the Rambam Health Care Campus in Haifa, Israel, and colleagues conducted a prospective cohort study in a tertiary referral center involving children who underwent tonsillectomy with or without adenoidectomy. A total of 82 children were included: 40 and 42 (48.8% and 51.2%) underwent cold adenotonsillectomy and PITA (22 with coblation and 20 with microdebrider), respectively.

The researchers found that the rate of one-week postoperative fever was 24.4%. Compared with cold adenotonsillectomy, PITA was associated with higher rates of fever one week postoperatively (odds ratio, 4.81) and referrals to a treating physician (35.7 versus 15%). Lower pain levels were seen in association with PITA (mean one-week daily visual analog scale, 3.4 ± 0.05 versus 4.13 ± 0.82), in addition to a shorter time to resuming a normal diet (mean, 3.4 ± 0.77 versus 4.07 ± 0.69 days). Between the different surgical techniques, there were no significant differences seen in hemorrhage, readmission, or halitosis rates.

“PITA was associated with higher rates of fever one week postoperatively, potentially resulting in increased referrals to treating physicians,” the authors write. “Based on our observations, we believe this fever may be of limited clinical significance and have no impact on patient outcomes.”

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