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Patient reported pain-related outcome measures after tonsil surgery: an analysis of 32,225 children from the National Tonsil Surgery Register in Sweden 2009–2016
Örebro universitet, Institutionen för hälsovetenskaper. Department of Anaesthesia and Intensive Care, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden. (CPoN)ORCID-id: 0000-0003-4718-3361
Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Sheikh Khalifa Medical City, Ajman, United Arab Emirates.
Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden; Division of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
Örebro universitet, Institutionen för hälsovetenskaper. (CPoN)ORCID-id: 0000-0001-8549-9039
2017 (engelsk)Inngår i: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 274, nr 10, s. 3711-3722Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

The objective of this study was to describe factors affecting pain after pediatric tonsil surgery, using patient reported pain-related outcome measures (pain-PROMs) from the National Tonsil Surgery Register in Sweden. In total, 32,225 tonsil surgeries on children (1 to\18 years) during 2009–2016 were included; 13,904 tonsillectomies with or without adenoidectomy (TE ± A), and 18,321 tonsillotomies with or without adenoidectomy (TT ± A). Adjustments were made for variables included in the register to compensate for contributable factors in the analysis. When compared to TE ± A for surgical indication obstruction, TT ± A resulted in lower pain-PROMs, shorter use of postoperative analgesics, earlier return to regular food intake, and lower risk for contact with health care services due to pain. Children who underwent TE ± A because of obstruction problems stopped taking painkillers and returned to normal eating habits sooner, compared to children who underwent TE ± A for infectious indications. In both indication groups, TE ± A performed with hot rather than cold technique (dissection and haemostasis) generally resulted in higher pain-PROMs. Older children reported more days on analgesics and a later return to regular food intake after TE ± A than younger ones. No clinically relevant difference between sexes was found. Between 2012 and 2016 (pre-and post-implementation of Swedish national guidelines for pain treatment), the mean duration of postoperative analgesic use had increased. In conclusion, TE ± A caused considerably higher ratings of pain-related outcome measures, compared to TT ± A. For TE ± A, cold surgical techniques (dissection and haemostasis) were superior to hot techniques in terms of pain-PROMs. Older children reported higher pain-PROMs after TE ± A than younger ones.

sted, utgiver, år, opplag, sider
Springer, 2017. Vol. 274, nr 10, s. 3711-3722
Emneord [en]
Children, Pain, PROM, Tonsillitis, Tonsillar hypertrophy, Tonsillectomy, Tonsillotomy
HSV kategori
Forskningsprogram
Anestesiologi; Oto-rhino-laryngologi; Vårdvetenskap
Identifikatorer
URN: urn:nbn:se:oru:diva-59111DOI: 10.1007/s00405-017-4679-4ISI: 000409888700021PubMedID: 28815308Scopus ID: 2-s2.0-85027510091OAI: oai:DiVA.org:oru-59111DiVA, id: diva2:1133806
Merknad

Funding Agency:

Swedish Association of Local Authorities and Regions

Tilgjengelig fra: 2017-08-16 Laget: 2017-08-16 Sist oppdatert: 2018-08-01bibliografisk kontrollert

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