Postoperative pain after adult tonsillectomy with plasmaknife compared to monopolar electrocautery


  • The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.

  • The Chief, Navy Bureau of Medicine and Surgery, Washington, DC, Clinical Investigation Program sponsored this study. The authors have no association with any products used in or inferred from this manuscript. Research data derived from Study Title, an approved Naval Medical Center, Portsmouth, VA IRB/IACUC protocol (CIP #2008.0052). The authors have no funding, financial relationships, or conflicts of interest to disclose.



Monopolar cautery is the most commonly used technique for tonsillectomy. The aim of the present study is to compare postoperative pain using a new technology, PlasmaKnife tonsillectomy (PKT), in comparison with monopolar cautery tonsillectomy (MCT).

Study Design:

Prospective, randomized, single-blinded, self-controlled study using paired organs.


Thirty-two adult patients, aged 18 to 30 years, scheduled for tonsillectomy for recurrent tonsillitis were included. Patients were randomly assigned to undergo PKT on one side and MCT on the opposite side. The primary outcome was self-rated daily pain assessed by using a 10-point scale. Patients were provided 21-day pain diaries and were phoned twice weekly by a research assistant to assess pain and remind them to complete diaries. Secondary outcomes included comparisons of operative time, blood loss, and postoperative complications.


Repeated measures analysis of variance comparing PKT to MCT during the 21-day postoperative period revealed no difference in postoperative pain between the two groups (P = .131). In addition, total operative time (P = .276) and blood loss (P = .418) did not differ significantly between PKT and MCT.


Adult subjects undergoing PKT do not experience less postoperative pain in comparison to MCT.