{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T13:27:12Z","timestamp":1780147632913,"version":"3.54.0"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>The primary aim of this study was to describe the current practice regarding pain management in relation to tonsil surgery among Ear Nose and Throat (ENT) clinics in Sweden. The secondary aim was to determine the impact of the provider\u2019s regime of rescue analgesics on the pain related Patient Reported Outcome Measures (pain-PROMs) from the Swedish Quality Register for Tonsil Surgery (SQTS).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials &amp; methods<\/jats:title>\n<jats:p>A descriptive cross-sectional study originating from a validated web-based questionnaire. The survey enrolled one respondent from each ENT clinic (47\/48 participated) nationally. Pain-PROMs from the SQTS, recorded from October 2019 to October 2022, were included (8163 tonsil surgeries).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Paracetamol was used by all enrolled ENT clinics as preemptive analgesia. The addition of COX inhibitors was used in 40% of the clinics. Betamethasone was usually administered, to prevent pain and nausea (92%). All clinics gave postdischarge instructions on multimodal analgesia with COX inhibitors and paracetamol. Rescue analgesics were prescribed after tonsillectomy for 77% of adults, 62% of older children, 43% of young children and less often after tonsillotomy. The most frequently prescribed rescue analgesic was clonidine in children (55%) and oxycodone in adults (72%).<\/jats:p>\n<jats:p>A high proportion of patients reported contact with health care services due to postoperative pain (pain-PROMs\/ SQTS). Tonsillectomy procedures were associated with the highest rates of contacts (children\/adolescents 13\u201315%; adults 26%), while tonsillotomy were associated with lower rates, (5\u20137% of children\/adolescents). There was no significant difference in the frequency of health care contacts due to pain regarding whether clinics routinely prescribed rescue analgesics or not after tonsillectomy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The Swedish analgesic regimen after tonsil surgery is good overall. Nevertheless, there is a need for increased awareness and knowledge to achieve optimal patient recovery. Pain-PROM data demonstrate the call for improvement in pain management after tonsil surgery.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0298011","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T18:35:44Z","timestamp":1709836544000},"page":"e0298011","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Pain management after tonsil surgery in children and adults\u2014A national survey related to pain outcome measures from the Swedish Quality Register for tonsil surgery"],"prefix":"10.1371","volume":"19","author":[{"given":"Maria","family":"Roskvist","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Alm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Nerfeldt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8549-9039","authenticated-orcid":true,"given":"Elisabeth","family":"Ericsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,3,7]]},"reference":[{"issue":"2","key":"pone.0298011.ref001","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1007\/s00405-020-06367-z","article-title":"Postoperative pain, pain management, and recovery at home after pediatric tonsil surgery.","volume":"278","author":"F Alm","year":"2021","journal-title":"Eur Arch Otorhinolaryngol."},{"key":"pone.0298011.ref002","article-title":"Establishment of resilience in a challenging recovery at home after pediatric tonsil surgery\u2014Children\u2019s and caregivers\u2019 perspectives.","author":"F Alm","year":"2021","journal-title":"Paediatric & Neonatal Pain"},{"issue":"1","key":"pone.0298011.ref003","first-page":"15","article-title":"[Optimal Postoperative Pain Management After Tonsillectomy: An Unsolved Problem].","volume":"95","author":"O Guntinas-Lichius","year":"2016","journal-title":"Laryngorhinootologie."},{"key":"pone.0298011.ref004","doi-asserted-by":"crossref","first-page":"110106","DOI":"10.1016\/j.ijporl.2020.110106","article-title":"A comprehensive examination of the immediate recovery of children following tonsillectomy and adenoidectomy","volume":"135","author":"BK Lao","year":"2020","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"2","key":"pone.0298011.ref005","doi-asserted-by":"crossref","first-page":"e819","DOI":"10.1097\/PR9.0000000000000819","article-title":"A descriptive analysis of pediatric post-tonsillectomy pain and recovery outcomes over a 10-day recovery period from 2 randomized, controlled trials.","volume":"5","author":"AC Postier","year":"2020","journal-title":"Pain Rep."},{"issue":"10","key":"pone.0298011.ref006","doi-asserted-by":"crossref","first-page":"3711","DOI":"10.1007\/s00405-017-4679-4","article-title":"Patient reported pain-related outcome measures after tonsil surgery: an analysis of 32,225 children from the National Tonsil Surgery Register in Sweden 2009\u20132016.","volume":"274","author":"F Alm","year":"2017","journal-title":"Eur Arch Otorhinolaryngol."},{"issue":"7","key":"pone.0298011.ref007","first-page":"589","article-title":"Practice, complications and outcome in Swedish tonsil surgery 2009\u20132018.","volume":"140","author":"F Lundstr\u00f6m","year":"2020","journal-title":"An observational longitudinal national cohort study. 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Critique and recommendations","volume":"29","author":"DF Polit","year":"2006","journal-title":"Research in nursing & health."},{"key":"pone.0298011.ref040","first-page":"17","article-title":"Preventive analgesia for postoperative pain control: a broader concept.","volume":"7","author":"N Vadivelu","year":"2014","journal-title":"Local and regional anesthesia"},{"issue":"2","key":"pone.0298011.ref041","first-page":"Cd001874","article-title":"Perioperative local anaesthesia for reducing pain following tonsillectomy","volume":"1999","author":"LJ Hollis","year":"2000","journal-title":"The Cochrane database of systematic reviews"},{"issue":"8","key":"pone.0298011.ref042","first-page":"Cd003997","article-title":"Steroids for improving recovery following tonsillectomy in children","volume":"2011","author":"DL Steward","year":"2011","journal-title":"The Cochrane database of systematic reviews"},{"issue":"4","key":"pone.0298011.ref043","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1046\/j.0283-9318.2003.00238.x","article-title":"Is the sufficiency of discharge instructions related to children\u2019s postoperative pain at home after day surgery?","volume":"17","author":"P Kankkunen","year":"2003","journal-title":"Scandinavian journal of caring sciences."},{"issue":"7","key":"pone.0298011.ref044","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1111\/anae.15299","article-title":"PROSPECT guideline for tonsillectomy: systematic review and procedure-specific postoperative pain management recommendations","volume":"76","author":"N Aldamluji","year":"2021","journal-title":"Anaesthesia"},{"issue":"11","key":"pone.0298011.ref045","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.23736\/S0375-9393.20.14391-8","article-title":"What has happened since the First World Congress on Pediatric Pain in 1988? 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