- After tonsillectomy in children, perioperative opioid prescriptions show no link to number of return visits for complications, with the exception of increased returns for constipation.
Why this matters
- Guidelines call for nonopioids as first-line choice for these children.
- These authors say that their findings support the possibility that opioid prescriptions and their duration can be reduced in this population.
- 59.6% of the children had 1+ perioperative fills.
- Perioperative opioid medication refills were not associated (aORs; 95% CIs) with return visits for:
- 4.1% no refills vs 4.3% any;
- 1.13 (0.95-1.34); or
- Secondary hemorrhage:
- 2.9% no refills vs 3.2% any;
- 0.90 (0.73-1.10).
- 1+ refills was associated with returns for constipation:
- 0.4% with no refills vs 0.7% with any;
- aOR, 2.02 (95% CI, 1.24-3.28).
- Duration of prescription was not associated with any return visit categories evaluated.
- 1 child had a return visit for opioid overdose.
- Cohort study of insurance claims data for 22,567 children (mean age, 7.8 years) undergoing tonsillectomy, 2016-2017.
- Return window evaluated was 2-14 days post-op.
- Funding: National Institute on Drug Abuse, others.
- Unmeasured confounding possible.
- Usual limitations of database information, including tracking only refills filed for insurance.