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Topic:

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Issue:

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Category:

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Title:

Postoperative Opioid Prescribing Practices and Patient Opioid Utilization in Pediatric Orthopaedic Surgery Patients

Author:

Mullen, Marguerite A. BA; Kim, Kang Woo BA; Procaccini, Michaela NP; Shipp, Michael M. MD; Schiller, Jonathan R. MD; Eberson, Craig P. MD; Cruz, Aristides I. Jr MD, MBA

Journal:

Journal of Pediatric Orthopaedics

Date:

January 2024

Reference:

44(1): p e91-e96, DOI: 10.1097/BPO.0000000000002543

Level Of Evidence:

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# of Patients:

280

Study Type:

Observational, Retrospective

Location:

Not specified

Summary:

This study aims to investigate the prescription volume and postoperative utilization rates of opioids among pediatric orthopedic surgery patients at a specific institution. It highlights the trend of overprescribing and underutilization of opioids, providing insights into postoperative opioid use.

Methods:

Pediatric patients under 18 years who underwent surgery from May 24, 2021, to December 13, 2021, were included. Data on opioid prescription volume and utilization were collected through surveys with parents/guardians. Analysis was conducted using Wilcoxon rank-sum tests, independent t-tests, Pearson correlation, and multivariable logistic regression.

Exclusions:

Patients without opioid utilization data (178 patients contributed only prescription volume data).

Results:

Of the 280 patients, 102 had complete opioid utilization data. Patients with upper extremity fractures received significantly fewer opioids at discharge compared to other surgeries (P=0.036). Higher BMI correlated with higher prescribed opioid doses (R² = 0.647, P < 0.001). The overall opioid utilization rate was 22.37%, with 50.6% of patients using no opioids. 96.2% of patients used opioids for 5 days or fewer, and most families had not disposed of excess opioids by postoperative day 10.

Conclusions:

Significant differences were found in opioid prescribing based on procedure and patient characteristics. Despite low overall opioid utilization in pediatric orthopedic surgery patients, there was considerable variation in opioid use. The study suggests a need for improved opioid prescribing practices and patient education on safe disposal.

Relevance:

Limitations:

Perspective:

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