title: [Estimation of postoperative pain after tonsillectomy in adults using QUIPS: an instrument to improve postoperative pain management].
abstract: BACKGROUND
  Tonsillectomy leads to strong postoperative pain. Pain management often is not optimal after tonsillectomy. To date, there exists no clear guideline for pain management after tonsillectomy.
  
  
  METHODS
  In a prospective study 65 tonsillectomy patients were examined at the first postoperative day within the QUIPS project. This allowed a standardised assessment of patients' characteristics, pain parameters, outcome and process parameters. The influence of these parameters on the patients' postoperative pain was estimated with univariate and multivariate statistic analysis.
  
  
  RESULTS
  All patients report of constant slight pain during the first postoperative day after tonsillectomy. Although maximal pain intensity was moderate, overall, patients were satisfied with the pain management. Pain management did not result in relevant side effects. Younger patients suffered significantly more from maximal pain than older patients. The same was obvious for patients who needed pain killers already prior to surgery. Perioperative antibiotic treatment and specific counselling about the possibilities of postoperative pain management reduced pain intensity highly significant in univariate and multivariate analysis. Patients receiving opioids on the ward postoperatively had significantly less pain.
  
  
  CONCLUSIONS
  QUIPS is a very good tool to evaluate the quality of postoperative pain management in one's own hospital. Next step, a detailed comparison to the best practise of other hospitals participating at QUIPS will follow in order to improve and standardize pain management for adult tonsillectomy patients.
authors.affiliation: HNO-Klinik, Universitätsklinikum der FSU Jena.
authors.forename: K
authors.initials: K
authors.lastname: Poller
authors.forename: G F
authors.initials: GF
authors.lastname: Volk
authors.forename: C
authors.initials: C
authors.lastname: Wittekindt
authors.forename: W
authors.initials: W
authors.lastname: Meissner
authors.forename: O
authors.initials: O
authors.lastname: Guntinas-Lichius
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D019985:Benchmarking / Q000592:standards; D004177:Dipyrone / Q000627:therapeutic use; D005260:Female; D019983:Guideline Adherence / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care; D010147:Pain Measurement / Q000379:methods* / Q000592:standards; D010149:Postoperative Pain / Q000175:diagnosis* / Q000188:drug therapy; D017060:Patient Satisfaction; D000039:Peritonsillar Abscess / Q000601:surgery*; D010892:Pirinitramide / Q000627:therapeutic use; D011446:Prospective Studies; D011594:Psychometrics / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014068:Tonsillectomy; D014069:Tonsillitis / Q000601:surgery*; D055815:Young Adult
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D010892:Pirinitramide; D004177:Dipyrone