Improved pain management after tonsil surgery in adults: a quality improvement programme

During 2018-2020, data from the Norwegian Tonsil Surgery Register (NTSR) showed large differences in recontact rates due to postoperative pain in the participating ear, nose and throat (ENT) units. On average, 27% (range 12-39%) of the patients had contacted the healthcare system due to problems with postoperative pain after tonsil surgery. Because of these high rates and large variations, we conducted a quality improvement project introducing a standardised pain management programme for adult patients. The goal was to reduce the pain-related recontact rate to below 15% in the participating ENT units.Five ENT units with an average recontact rate of 33.6% (range 29.0-38.1%) participated in this project. In a workshop, the units agreed on a standardised pain management programme consisting of a patient information brochure and a prescription including multimodal analgesics with paracetamol and COX-2 inhibitor (etoricoxib) with supplementary analgesic (tramadol). The units introduced the programme in their daily practice from June 2022 to July 2024. At follow-up in 2024, the recontact rate had decreased from 33.6% to 15.5% in the participating units.Introducing a standardised pain management programme, including a standard prescription of analgesics and a standard patient information brochure, seems to improve the patients' pain management after tonsil surgery. This study shows that data from the NTSR can identify areas requiring improvement, initiate improvement projects and evaluate the changes in clinical practice.