Opioid prescriptions for pediatric patients following surgical
procedures have dropped significantly
Study suggests larger trend of moving away from routine opioid
prescriptions after surgery

Date:
April 4, 2022
Source:
Children's Hospital of Philadelphia
Summary:
Researchers found that opioid prescriptions for children who
underwent one of eight common outpatient surgeries declined over a
period of five years. These findings suggest that clinicians are
using more discretion when considering which pediatric patients
require an opioid prescription after their procedures.



FULL STORY ========================================================================== Researchers from Children's Hospital of Philadelphia (CHOP) and
the University of Pennsylvania School of Medicine found that opioid prescriptions for children who underwent one of eight common outpatient surgeries declined over a period of five years. These findings suggest
that clinicians are using more discretion when considering which pediatric patients require an opioid prescription after their procedures. The
findings were published online today by the journal Pediatrics.


========================================================================== Opioids are routinely prescribed after a surgery to help pediatric
patients manage mild or moderate pain. However, recent studies
have suggested that recovery is similar with limited or no opioid
use. Additionally, opioids prescribed to children can result in
respiratory depression, which causes carbon dioxide to not be expelled
from the lungs properly, and the continued use of those opioids, after
acute pain has resolved. Despite these findings, no prior studies had
looked at recent data on national opioid trends for surgery in children
in the context of whether there has been any shift away from prescribing opioids more broadly.

"Children grow throughout their childhood, and because opioids are often prescribed based on weight, we cannot assume that what is appropriate
for a 5- year-old could also apply to an adolescent," said the study's
lead author Tori N. Sutherland, MD, MPH, an attending anesthesiologist
in the Department of Anesthesiology and Critical Care Medicine at CHOP
and Assistant Professor of Anesthesiology at Penn Medicine. "In our
study, we wanted to be responsible with our data and consider surgical distribution by age group." In this study, the researchers used data from
a private insurance database to study opioid-nai"ve patients under the
age of 18 who underwent one of eight surgical procedures between 2014 and
2019. The procedures included in the study ranged from tonsillectomies
and dental surgeries to removal of the appendix and knee surgery. The
primary outcome of the study was whether a prescription for opioids was
filled within 7 days of surgery, and the secondary outcome was the total
amount of opioid dispensed. A total of 124,249 patients were included in
the study. Patients were separated by age into adolescents, school-aged children and preschool-aged children.

The researchers found that the percentage of children who had an
opioid prescription filled after their surgery dropped in all three
age categories.

For adolescents, prescriptions dropped from 78.2% to 48%; for school-aged children, from 53.9% to 25.5%; and for preschool-aged children, from
30.4% to 11.5%. Additionally, the average morphine milligram equivalent dispensed declined by approximately 50% across all three age groups.

Additionally, the researchers also found that there was a more precipitous decline in opioid prescriptions beginning in late 2017, first in
the adolescent group and then followed by school- and preschool-aged
children. This trend appeared to represent a "trickle down" effect, but
more research is needed to explore the difference in trends by age group.

"Our findings demonstrate that pain treatment for children and adolescents undergoing surgery has changed dramatically over the past 5 years," said
Mark Neuman, MD, senior author and Associate Professor of Anesthesiology
and Critical Care at the University of Pennsylvania Perelman School
of Medicine.

"Understanding what these trends mean for patient experiences and
health outcomes is a key next step." This study was supported by grant R01DA042299 from the National Institute on Drug Abuse and the University
of Pennsylvania's McCabe Foundation.


========================================================================== Story Source: Materials provided by
Children's_Hospital_of_Philadelphia. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Tori N. Sutherland, Hannah Wunsch, Craig Newcomb, Scott Hadland,
Lakisha
Gaskins, Mark D. Neuman. Trends in Routine Opioid Dispensing
After Common Pediatric Surgeries in the United States:
2014-2019. Pediatrics, 2022; DOI: 10.1542/peds.2021-054729 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/04/220404082859.htm

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