Journal article
Opioids and Pediatric Urology: A Prospective Study Evaluating Prescribing Habits and Patient Postoperative Pain and Narcotic Utilization
Journal of pediatric urology, Vol.19(3), pp.295.e1-258.e8
06/2023
DOI: 10.1016/j.jpurol.2022.12.018
Abstract
Introduction
Few pediatric urologists believe patients require a majority of the doses of opioids prescribed to them postoperatively. Seeking a better understanding of postoperative pain and analgesia in pediatric urology patients may help reduce opioid over prescription while still adequately managing postoperative pain.
Objective
We sought to better understand: 1) the postoperative pain levels experienced by pediatric urology patients, 2) the factors that correlate with postoperative pain and number of opioids consumed following pediatric urologic procedures, and 3) the patients who do not require opioids after surgery.
Study design
Pediatric patients undergoing circumcision, inguinal hernia repair, orchidopexy, or hypospadias repair were eligible to participate. Patients were enrolled in the prospective cohort on the day of the procedure. For each of the first 7 postoperative days, patients' parents completed a text message-based questionnaire, quantifying their child's pain level and the doses of pain medication the child consumed.
Results
165 participants were enrolled. 57 patients underwent circumcision, 54 underwent orchiopexy, 32 underwent hypospadias repair, and 22 underwent inguinal hernia repair. For all procedure types, pain scores (p < 0.01) and doses of oxycodone consumed were highest on postoperative day one and steadily declined thereafter. Overall, average 7-day pain score (2.02; 0.86–5.14) and doses of narcotics consumed (3.50; 0–5) were low. Patients in each surgical subgroup were prescribed narcotics in excess of what was consumed. There was an average excess of 10.9 doses (0–39.0) for hypospadias repair, 8.6 (1.0–30.0) for circumcision, 9.0 (3.0–21.0) for inguinal hernia repair, and 6.1 (0–22.0) for orchiopexy.
Discussion
Overall, reported pain scores and number of narcotics consumed were low regardless of surgery type. Opioids were overprescribed regardless of surgery type.
Conclusions
Our findings indicate that level of pain and opioid use varies by procedure type, but that number of narcotics prescribed greatly exceeds number needed.
Details
- Title: Subtitle
- Opioids and Pediatric Urology: A Prospective Study Evaluating Prescribing Habits and Patient Postoperative Pain and Narcotic Utilization
- Creators
- Tomas LenceRobert ThinnesAlexander J. FosterChristopher C. CooperGina LockwoodPatrick Ten EyckZachary RyeChaorong WuDenise JuhrDouglas W. Storm
- Resource Type
- Journal article
- Publication Details
- Journal of pediatric urology, Vol.19(3), pp.295.e1-258.e8
- DOI
- 10.1016/j.jpurol.2022.12.018
- ISSN
- 1477-5131
- eISSN
- 1873-4898
- Language
- English
- Electronic publication date
- 01/2023
- Date published
- 06/2023
- Academic Unit
- Biostatistics; Internal Medicine; Neurology; Stead Family Department of Pediatrics; Urology; Medicine Administration
- Record Identifier
- 9984361596402771
Metrics
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