An Evidence-Based Guideline Supporting Restricted Opioid Prescription after Pediatric Appendectomy

Space: StayCurrentMD Author: Mollie R. Freedman-Weiss, Alexander S. Chiu, David Worhunsky, Alefteria Manchisi, Isabel Torres-Maldonado, Lisa Sagnella, Michael G. Caty, Robert A. Cowles, Doruk E Ozgediz, Emily R. Christison-Lagay, Daniel G. Solomon, David H. Stitelman Published:

Author / Expert

Mollie R. Freedman-Weiss, Alexander S. Chiu, David Worhunsky, Alefteria Manchisi, Isabel Torres-Maldonado, Lisa Sagnella, Michael G. Caty, Robert A. Cowles, Doruk E Ozgediz, Emily R. Christison-Lagay, Daniel G. Solomon, David H. Stitelman

Topic overview

Abstract

Background/Purpose

Surgeon overprescription of opioids is a modifiable contributor to the opioid epidemic. No clear guidelines exist for prescribing opioids to younger patients after surgery. We sought to determine postoperative opioid needs in pediatric/young adult patients after laparoscopic appendectomy.

Methods

Patients 5–20 years old who underwent laparoscopic appendectomy were included for study. All consented patients underwent chart review and were additionally called for an attempted interview. Caregivers were queried on analgesic use and adequacy of pain relief. The main outcome measures were: quantity of opioid used, desire for an opioid, presence of pain ≥4/10, and need for follow-up/call owing to pain. All opioids were converted into morphine milligram equivalents (MME).

Results

Seventy-three patients qualified for the study, 49 of whom completed a postoperative telephone interview. Of the interviewees, 83% did not use or desire an opioid and reported pain

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