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Persistent Opioid Use Among Children, Adolescents, and Young Adults After Common Cleft Operations

Katelyn G Bennett1, Calista M Harbaugh2, Hsou Mei Hu1

  • 1Section of Plastic Surgery.

The Journal of Craniofacial Surgery
|July 31, 2018
PubMed

Insights

New persistent opioid use after cleft surgery affects 4.4% of pediatric patients, potentially leading to chronic opioid dependence. Risk factors include distractor placement, increasing age, and gastrointestinal comorbidities.

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Opioid Prescribing Practices

Background:

  • Surgical procedures are a significant contributor to opioid initiation and chronic use.
  • Rates of prolonged opioid use following pediatric surgeries are not well-established.
  • This study investigates new persistent opioid use after common cleft operations.

Purpose of the Study:

  • To determine the incidence of new persistent opioid use after cleft-related procedures in young patients.
  • To identify risk factors associated with prolonged opioid use post-pediatric surgery.
  • To understand the potential transition from acute to chronic opioid use in this population.

Main Methods:

  • Analysis of claims data from the Truven Marketscan databases (2010-2014).
  • Inclusion of opioid-naive patients (ages 8-25) undergoing one of ten cleft procedures.
  • Comparison with age-matched, non-surgical control patients.

Main Results:

  • New persistent opioid use was observed in 4.4% of cleft patients versus 0.1% in controls.
  • Distractor placement (OR 5.34) was significantly associated with increased opioid use.
  • Increasing age (OR 1.11) and gastrointestinal comorbidities (OR 7.37) were also identified as risk factors.

Conclusions:

  • New persistent opioid use is a notable outcome following cleft-related surgical procedures.
  • This pattern of use in children, adolescents, and young adults may signify a pathway to chronic opioid dependence.
  • Identifying risk factors is crucial for mitigating long-term opioid use.
Abstract

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