A PROSPECTIVE, MODALITY-DIFFERENTIATED COMPARATIVE EVALUATION OF HYDROGEN PEROXIDE–INDUCED OXIDATIVE CHEMICAL CAUTERISATION VERSUS BIPOLAR ELECTROSURGICAL COAGULATION IN MODULATING POST-TONSILLECTOMY MUCOSAL REPARATIVE DYNAMICS, EPITHELIALISATION KINETICS, AND NOCICEPTIVE TRAJECTORY PROFILES"

Abstract

Background: Tonsillectomy, a commonly performed ENT surgery, is often complicated by significant postoperative pain and delayed healing. Traditional hemostatic techniques, such as bipolar electrocautery, can cause thermal tissue damage, leading to increased morbidity. Hydrogen peroxide (H₂O₂), a mild oxidizing agent, may offer an alternative through chemical cauterization with reduced tissue trauma.

Objective: To compare the effects of 3% hydrogen peroxide chemical cauterization and bipolar electrocautery on postoperative healing, pain, and complication rates in patients undergoing tonsillectomy.

Methods: This prospective randomized study included 100 patients (aged 12–40) undergoing elective tonsillectomy. Patients were randomly assigned to either the H₂O₂ group (n=50) or the bipolar cautery group (n=50). Pain was assessed using the Visual Analog Scale (VAS) at 6, 24, 48, and 72 hours, and on postoperative day 7. Healing progression and complication rates (secondary hemorrhage, infection, dehydration) were recorded. Statistical analysis was performed using SPSS v26.0.

Results: Patients in the H₂O₂ group reported significantly lower VAS scores at all time points (P<0.001). Healing was faster, with complete epithelialization by 10.5 ± 2.0 days compared to 14.0 ± 2.5 days in the bipolar group (P<0.001). The incidence of secondary hemorrhage was notably lower in the H₂O₂ group (2% vs. 12%, P=0.045). Additionally, the total treatment cost was approximately 8.4 times lower in the H₂O₂ group.

Conclusion: Hydrogen peroxide chemical cauterization significantly reduces postoperative pain, accelerates healing, and minimizes complications and costs, suggesting it as a safer, more cost-effective alternative to bipolar electrocautery in tonsillectomy patients.