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Objective: 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's regime of rescue analgesics on the pain related Patient Reported Outcome Measures (pain-PROMs) from the Swedish Quality Register for Tonsil Surgery (SQTS). Materials & methods: 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). Results: 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%). 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 13–15%; adults 26%), while tonsillotomy were associated with lower rates, (5–7% 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. Conclusion: 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. [ABSTRACT FROM AUTHOR]

Objective.—To evaluate delivery outcome in women who used drugs for migraine during pregnancy with special reference to sumatriptan. Background.—The safety of the use of drugs for migraine during pregnancy is not established. Design and Methods.—Using the Swedish Medical Birth Registry which contains information on drug use reported by women at the first antenatal visit, 912 infants (born in 905 deliveries) whose mothers had used drugs for migraine were identified, the majority of whom (n = 658) had used sumatriptan. Results.—These women differed from the general population of women who had delivered by being older and more often of first parity, but they had similar smoking habits. Slightly more often, the infants were preterm, and they had a birth weight less than 2500 g; neither of these effects were statistically significant. There seemed to be no difference between infants exposed to sumatriptan and those exposed to other drugs used for migraine. No increase in the rate of congenital malformations was seen. Conclusions.—The data indicate that use of sumatriptan in early pregnancy does not result in a large increase in teratogenic risk, but do not rule out the possibility of a moderate increase in risk for a specific birth defect. [ABSTRACT FROM AUTHOR]