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Variability in opioid prescribing for children undergoing ambulatory surgery in the United States

William C Van Cleve1, Eliot B Grigg2

  • 1Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States.

Journal of Clinical Anesthesia
|August 14, 2017
PubMed

Insights

Opioid prescribing for pediatric ambulatory surgery varied significantly by patient age and procedure type between 2007 and 2014. Acetaminophen with codeine and acetaminophen with hydrocodone were the most common opioid analgesics prescribed.

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Pharmacology

Background:

  • Opioid analgesics are frequently prescribed for post-operative pain management in pediatric patients.
  • Understanding prescribing patterns is crucial for optimizing pain control and minimizing risks associated with opioid use.

Purpose of the Study:

  • To describe opioid prescribing patterns for ambulatory pediatric surgery in the United States.
  • To analyze variations in opioid use based on patient age and surgical procedure.

Main Methods:

  • Retrospective review of the Truven Health Marketscan Commercial Claims and Encounters database.
  • Analysis of 929,874 ambulatory surgical encounters in patients under 18 years of age.
  • Examination of analgesic prescriptions, including opioid type and co-prescription with acetaminophen or NSAIDs.

Main Results:

  • The likelihood of receiving a post-operative analgesic prescription increased with age, from 18.2% in infants to 71.7% in teens.
  • Acetaminophen with codeine was most common for infants (63.8%), while acetaminophen with hydrocodone was most common for teens (53.6%).
  • Acetaminophen with codeine and acetaminophen with hydrocodone were the predominant opioid analgesics across all procedure types.

Conclusions:

  • Significant variability exists in post-operative analgesic prescribing following pediatric ambulatory surgery.
  • Prescribing patterns differ based on patient age and the specific surgical procedure performed.
  • These findings highlight the need for standardized guidelines to optimize opioid prescribing in pediatric surgical care.
Abstract

Keywords:
Ambulatory surgical proceduresAnalgesicsOpioidPainPediatrics

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