Objectives: The primary aim of this study was to describe pain treatment in relation to surgery of the tonsils in Sweden. The secondary aim was to determine the impact of the provider’s regimens of analgesic treatment on the patient reported pain-related outcome measures (pain-PROMs) from National Tonsil surgery Register in Sweden (NTSRS).
Methods: A descriptive cross-sectional study based on a web-questionary enrolled one respondent from 47 out of 48 invited ENT-clinics in Sweden. Pain-PROMs from the NTSRS were included.
Results: Pre-emptive analgesia pre- and intraoperatively was paracetamol (100%), normally administered iv, and cox-inhibitors iv (74%). To prevent pain and nausea, betamethasone iv (92%/n=43) was administered. Paracetamol combined with cox-inhibitors (Ibuprofen) were recommended by all clinic as a basic analgesic regime postoperatively. The clinics usually prescribed (66%) higher dose of paracetamol day 1-3, followed by a reduced dose days 4-8. Additional rescue analgesics were prescribed after tonsillectomy to older children (62%/n=29), and to young children by 43%/n=20. The most common rescue analgesic was clonidine (55%), followed by oxicodon (34%), morphine (4%), and ketobemidone (2%). Pain-PROMs (NTSRS) showed the frequency of contacts with healthcare due to pain in children (15%). There was no significant difference in percentage of contacts due to pain regarding if clinics routinely prescribed rescue analgesics after tonsillectomy or not.
Conclusions: The national analgesic regime after tonsil surgery is overall good. Despite this, there is a need for rise in awareness and knowledge to achieve optimal patient recovery. Pain-PROM data demonstrate the complexity of pain management after tonsil surgery.