Requiring parental consent for opioids reduces their use in common pediatric procedure

  • Whelan RL & al.
  • Laryngoscope
  • 26 Dec 2018

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Requiring written parental consent for opioid prescriptions led to a significant decrease in the use of opioids in pediatric patients undergoing adenotonsillectomy without an increase in postoperative complications or complaints.

Why this matters

  • Studies suggest that patients aged 13-21 years who undergo common pediatric procedures are at increased risk of persistent opioid use 6 months after surgery.
  • The study examines the effect of a recently passed Pennsylvania law that requires parent or guardian consent for opioid use in minors, limits opioid prescriptions to 7 days, and requires physicians to document justification for medication necessity.

Study design

  • 300 patients (age, ≤18 years) who underwent adenotonsillectomy 6 months before/after mandated opioid consent forms implementation were evaluated.
  • Funding: None.

Key results

  • Opioid prescription provided for 211 patients, 112 preconsent and 99 postconsent.
  • Mean of total opioid prescribed (milligrams/kilogram) was significantly higher preconsent vs postconsent (4.8±5.6 vs 3.2±4.7; P=.003).
  • Similar decrease observed in total number of days prescribed between preconsent vs postconsent groups (5.5±4.9 vs 4.4±3.6; P=.025).
  • No difference observed between groups for:
    • nursing telephone calls (P=.134);
    • follow-up appointments (P=.732);  
    • emergency department visits (P=.083); or
    • surgical intervention for postoperative bleeding concern (P=.994).

Limitations

  • Amount of oxycodone that child consumed not examined.

Coauthored with Antara Ghosh, PhD

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