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Pain
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Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Unused opioid drugs are staying at home and being found by kids or other family members, contributing to the opioid epidemic. — Alex, Addressing the Opioid Crisis: 2018 Pediatric Surgery Practice Gap #1 · 1:20
Addressing the Opioid Crisis: 2018 Pediatric Surgery Practice Gap #1
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Drs. Todd Ponsky, Alex Casar, Alex Gibbons, and Rae Hanke review 2018 Practice Gap #1: Addressing the Opioid Crisis, as identified by the APSA Professional Development Committee.
video · Jun 2019
There are no procedure-specific guidelines for opiate use in pediatric patients like there are in adults. — Isabel Hageman, PAPS -Perioperative Opioid Use In Paediatric Inguinal Hernia Patients- A Systematic Review And Retrospective Audit Of Practice - Isabel Hageman · 0:40
PAPS -Perioperative Opioid Use In Paediatric Inguinal Hernia Patients- A Systematic Review And Retrospective Audit Of Practice - Isabel Hageman
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Listen to Isabel Hageman gave her presentation of "Perioperative Opioid Use In Pediatric Inguinal Hernia Patients- A Systematic Review And Retrospective Audit Of Practice" at the first ever Best of the Best in Pediatric Surgery event.
video11:59 · May 2022
David Grabski, MD - Best of the Best in Pediatric Surgery 2024
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Watch APSA's Dr. David Grabski’s presentation on “Post-Operative Opioid Reduction Protocol Reduces Racial Disparity of Clinical Outcome in Children” at the 2024 Best of the Best in Pediatric Surgery event!
Moderators: Todd Ponsky, Cecili
video9:15 · Feb 2024
Acetaminophen (Tylenol) plus NSAIDs (e.g., ibuprofen/Motrin) are equally as effective as narcotics for pain relief without the side effects of headache, constipation, and nausea. Opioid over prescription: Practice Gap discussion at Update Course 2018 · 0:43
Opioid over prescription: Practice Gap discussion at Update Course 2018
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At the 6th Annual Pediatric Surgery Update Course, Drs Charles Snyder, Craig Lillehei and David Powell discussthe top ten practice gaps of 2018. Here they discuss the number one practice gap, opioid over prescription, focused on interventio
video8:27 · Sep 2018
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Opioid over prescription: Practice Gap discussion at Update Course 2018
Acetaminophen (Tylenol) plus NSAIDs (e.g., ibuprofen/Motrin) are equally as effective as narcotics for pain relief without the side effects of headache, constipation, and nausea.
clinical0:43 ↗
5% of children will become long-term opioid users if they are given opioids, according to research by Kelly Harbaugh at the speaker's institution.
epidemiological1:14 ↗
The problem of pediatric opioid use exists not just with surgeons but also with dentists and all kinds of healthcare providers.
epidemiological1:14 ↗
Subsequent opioid prescriptions children receive are not necessarily from the surgeon who gave the first prescription.
epidemiological1:14 ↗
Excess opioids given to patients are probably the biggest entry point for narcotics into our system and subsequent abuse.
opinion1:14 ↗
Parents keep leftover opioid prescriptions, which then leak into society.
epidemiological1:14 ↗
The most common reason for house burglaries now is those seeking drugs left over in drawers or medicine cabinets.
epidemiological2:42 ↗
A decade ago, the IOM (Institute of Medicine) was telling clinicians they weren't adequately managing people's pain.
Host summaryThe host summarizing the discussion — not the host's own clinical position4:07 ↗
Consumption of hydrocodone increased 200% and oxycodone increased 500%.
Host summaryThe host summarizing the discussion — not the host's own clinical position4:07 ↗
Opioid deaths have quadrupled.
Host summaryThe host summarizing the discussion — not the host's own clinical position4:07 ↗
Pediatric hospitalizations and emergency ward visits related to opioids have doubled.
Host summaryThe host summarizing the discussion — not the host's own clinical position4:07 ↗
Most pediatric opioid-related hospitalizations and emergency visits are a result of prescribed medications.
Host summaryThe host summarizing the discussion — not the host's own clinical position4:07 ↗
After stopping routine narcotic prescriptions for hernias and appendectomies, the speaker has not had one single patient call complaining about pain management.
clinical5:20 ↗
Most urban areas now have traces of opioids in their water supply because so many people flush medications down the toilet.
epidemiological7:21 ↗
Children have presented with bad toxic reactions after swallowing fentanyl patches, mistaking them for candy or gum.
clinical7:21 ↗
Michigan has a network (Michigan Open/opiate network) that conducts drives at high schools throughout the state where parents or patients bring opiates for collection, removing immense amounts of opiates from the system.
epidemiological7:50 ↗
David Grabski, MD - Best of the Best in Pediatric Surgery 2024
The intervention was based on IV Tylenol, directed post-operative pain education seminars for related faculty and staff, and standardized post-surgical sign out.
clinicalDavid Grabski0:17 ↗
The study included 250 children under 1 year old who underwent non-emergent abdominal surgery in either the NICU or the acute care floor.
clinicalDavid Grabski1:00 ↗
The intervention reduced post-operative opiate use by 98% in the study population.
clinicalDavid Grabski2:00 ↗
In the pre-intervention cohort, the median postoperative morphine equivalence for Black children was 13 mg per kilogram, while for White children it was 2 mg per kilogram, and for Hispanic children it was 3.5 mg per kilogram.
epidemiologicalDavid Grabski2:30 ↗
Black children received a sixfold increase in post-operative opiate use compared to their White peers in the pre-intervention cohort.
epidemiologicalDavid Grabski3:00 ↗
In the post-intervention cohort, the median postoperative morphine equivalence in Black children reduced to just above 0 mg per kilogram, while for White children it was 0.05 mg per kilogram, and for Hispanic children it was 0.1 mg per kilogram, with these findings being statistically equivalent.
clinicalDavid Grabski3:20 ↗
There was no statistical difference in demographic or clinical variables in the pre-intervention or post-intervention cohort when analyzed by race.
epidemiologicalDavid Grabski4:00 ↗
The type of surgery performed in each cohort was proportionally equivalent by race.
epidemiologicalDavid Grabski4:20 ↗
There was no difference in postoperative pain scores in any racial group.
clinicalDavid Grabski4:30 ↗
The median total length of stay for Black children in the pre-intervention cohort was 45 days, while for White children it was 16 days.
epidemiologicalDavid Grabski4:40 ↗
Following the intervention, the total length of stay for Black children was 8 days, which was identical to White children.
clinicalDavid Grabski5:00 ↗
A racial disparity was found in the pre-intervention cohort in length of post-operative intubation and TPN usage, both of which were eliminated following the clinical protocol.
clinicalDavid Grabski5:15 ↗
Preliminary data suggests there might be a disparity in regional anesthesia use.
opinionDavid Grabski5:42 ↗
Standardization at all levels (pre-surgery, surgery, post-surgery, and throughout the NICU phase) was critical to the work.
opinionDavid Grabski6:00 ↗
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