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Opioid Prescribing in the Pediatric Orthopaedic Trauma Population

Robert T Simril1, Brian P Scannell1, Meghan K Wally1

  • 1Department of Orthopaedic Surgery, Carolinas HealthCare System, Charlotte, North Carolina; Carolinas Healthcare System Research Center of Excellence, Carolinas HealthCare System, Charlotte, North Carolina.

Journal of Surgical Orthopaedic Advances
|February 20, 2019
PubMed

Insights

Most children with orthopaedic injuries receive opioid prescriptions. Older children and adolescents are more likely to receive higher opioid dosages, indicating a need for standardized pediatric pain management guidelines.

Area of Science:

  • Pediatric Orthopaedics
  • Pain Management
  • Pharmacology

Background:

  • Opioid prescribing for pediatric orthopaedic injuries lacks standardized guidelines.
  • Understanding current prescribing patterns is crucial for developing evidence-based recommendations.

Purpose of the Study:

  • To describe opioid prescribing patterns in pediatric patients with orthopaedic injuries.
  • To identify factors influencing opioid prescription and dosage in this population.

Main Methods:

  • Retrospective chart review of 124 pediatric orthopaedic trauma patients.
  • Data collected included demographics, injury details, fracture fixation, and opioid prescription specifics.
  • Analysis focused on opioid utilization rates and dosage variations based on age and treatment type.

Main Results:

  • 82.3% of pediatric patients received opioid prescriptions post-injury.
  • Opioids were commonly prescribed after operative fixation (nearly 100%) but less so after closed reduction (39.5%).
  • Hydrocodone-acetaminophen was the most frequent prescription (93%), though adolescents were prescribed other agents and higher daily dosages (36.73% received >50 MME/day).

Conclusions:

  • Opioid prescribing is prevalent among children with orthopaedic injuries, with higher dosages for older patients.
  • Current prescribing practices show variability, particularly concerning dosage and drug choice for adolescents.
  • Further research is needed to establish standardized guidelines for opioid use in pediatric orthopaedic trauma care.

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