Takeaway
- Postoperative opioids are not needed to control pain in children following umbilical/epigastric herniorrhaphy, appendectomy, and other common surgeries, as long as adequate nonopioid analgesics are provided.
Why this matters
- Nearly all patients in this study who received a postoperative opioid prescription used less than prescribed, and extra opioid medications were often kept unlocked and undisposed.
Study design
- 675 patients (age, <18 years) who were undergoing umbilical or epigastric herniorrhaphy, laparoscopic appendectomy, inguinal herniorrhaphy and/or hydrocelectomy, adenoidectomy, circumcision, percutaneous pinning for elbow fracture, or scrotal incision orchiopexy were identified.
- Among the 675 eligible patients, 404 caregivers responded.
- Funding: Blue Cross Blue Shield of Michigan.
Key results
- A discharge opioid prescription was given to 22% of the patients (median, 10 doses; 25th-75th percentile, 6-15).
- Acetaminophen (88%) and ibuprofen (78%) use was common.
- Overall pain control reported was good (82%), adequate (14%), or poor (4%).
- Lack of a discharge opioid prescription was not associated with (opioid vs no opioid):
- poor pain control (3.4% vs 4.8%; P=.77);
- postdischarge opioid prescription (4.6% vs 1.3%; P=.07); and
- pain-related emergency department visit (1.1% vs 0.6%; P=.52).
Limitations
- Single-center, nonrandomised design.
Coauthored with Chitra Ravi, MPharm
References
References
