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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 University, School of Health Sciences. Department of Anaesthesia and Intensive Care. (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 University, School of Health Sciences. (CPoN)ORCID iD: 0000-0001-8549-9039
2017 (English)In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 274, no 10, p. 3711-3722Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
Springer, 2017. Vol. 274, no 10, p. 3711-3722
Keyword [en]
Children, Pain, PROM, Tonsillitis, Tonsillar hypertrophy, Tonsillectomy, Tonsillotomy
National Category
Otorhinolaryngology Anesthesiology and Intensive Care Nursing
Research subject
Anaesthesiology; Oto-Rhino-Laryngology; Nursing Science
Identifiers
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
Note

Funding Agency:

Swedish Association of Local Authorities and Regions

Available from: 2017-08-16 Created: 2017-08-16 Last updated: 2017-11-07Bibliographically approved

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Alm, FredrikEricsson, Elisabeth

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