Reducing Opioid Prescriptions in Outpatient Pediatric Urological Surgery

Area of Science:

• Pediatric Surgery
• Pain Management
• Opioid Prescribing Practices

Background:

• Opioid overprescribing is a significant concern in pediatric surgery.
• Understanding factors influencing opioid consumption is crucial for safe pain management.
• The Plan-Do-Study-Act (PDSA) cycle is a framework for quality improvement.

Purpose of the Study:

• To evaluate the effectiveness of a 2-phase PDSA cycle in reducing opioid prescriptions after pediatric urological surgery.
• To determine if decreased opioid prescribing impacts postoperative pain scores in children.

Main Methods:

• A prospective study involving children undergoing outpatient urological procedures.
• Data collection included opioid dosing, pain scores (Parents' Postoperative Pain Measure), age, and procedure type.
• Phase 1 prescribed 10 opioid doses; Phase 2 reduced prescriptions by 50%.

Main Results:

• 98 children participated; 81 received opioid prescriptions.
• No significant difference in opioid doses used between preintervention and postintervention groups (median 2 doses).
• No significant differences in pain scores were observed between the 5-dose and 10-dose groups across three days.

Conclusions:

• Opioid prescriptions can be safely reduced in outpatient pediatric surgery without compromising pain control.
• Physician prescribing patterns appear to be a larger determinant of opioid consumption than patient pain levels.