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Improving pain management after pediatric tonsil surgery – an ongoing project
Örebro University, School of Health Sciences. Department of Anaesthesia and Intensive Care. (CPoN)ORCID iD: 0000-0003-4718-3361
Astrid Lindgrens barnsjukhus, Karolinska universitetssjukhus, Stockholm.
Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Sheikh Khalifa Medical City, Ajman, United Arab Emirates.
Karolinska Universitetssjukhuset, Huddinge.
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2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

The National Tonsil Surgery Register in Sweden collects perioperative data from health care professionals and patient reported outcome measures 30 days and 6 months after surgery. Since 2009, patient-reported outcome measures, include questions related to pain.

Objective: To illustrate the process of improvements, efforts, and the use of a quality register in pain, and pain management after tonsil surgery in Sweden.

Method: Quantitative and qualitative research.

Results: Registry data indicated unrelieved postoperative pain with a high proportion of health care contacts. This resulted in the implementation of the Swedish National Guidelines (2013), and patient information published on the website www.tonsilloperation.se. The guidelines recommend multimodal pain treatment with paracetamol combined with COX-inhibitors, and if necessary, oral clonidine rather than opioids as rescue analgesics. A national survey (2015) showed that Swedish ENT-professionals’ opinions of, and the ENT-departments adherence to the guidelines were good. According to the national registry data (2017), the implementation has resulted in longer use of post-operative analgesic and fewer contacts with healthcare. Simultaneously, registry data showed that operating methods and techniques, age, and indication for surgery affect the pain outcome. Results from age-oriented pain diaries and qualitative interviews (2017-2018) capture the children’s and caregivers’ perspectives on pain, and pain treatment. Preliminary results show that type of pain treatment affects the quality of the postoperative care and recovery.

Conclusion: Pain management after tonsil surgery has been, and still is, a challenge for ENT-professionals and constant improvements are necessary.

Place, publisher, year, edition, pages
2018.
National Category
Medical and Health Sciences Other Medical Sciences not elsewhere specified
Research subject
Anaesthesiology; Oto-Rhino-Laryngology; Caring Sciences w. Medical Focus
Identifiers
URN: urn:nbn:se:oru:diva-69767OAI: oai:DiVA.org:oru-69767DiVA, id: diva2:1257807
Conference
14th Congress of the European Society of Pediatric Otorhinolaryngology, Stockholm, Sweden, June 2-5, 2018
Available from: 2018-10-22 Created: 2018-10-22 Last updated: 2018-10-24Bibliographically approved

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Alm, FredrikEricsson, Elisabeth

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