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Standardization and Reduction of Narcotics After Pediatric Tonsillectomy
Daniel C O'Brien1, Habib Zalzal1, David Adkins2
1Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA.
Summary
A quality improvement project reduced narcotic prescriptions after pediatric tonsillectomy. Caregiver satisfaction with pain management remained consistent, indicating successful pain control with fewer narcotics.
Area of Science:
- Pediatric surgery
- Pain management
- Quality improvement
Background:
- Post-tonsillectomy pain management often involves narcotics.
- Non-standardized regimens can lead to high narcotic use.
- Caregiver satisfaction is a key outcome measure.
Purpose of the Study:
- To assess caregiver satisfaction with a non-standardized pain regimen post-pediatric tonsillectomy.
- To implement a quality improvement project (QIP) aimed at reducing narcotic prescriptions.
- To evaluate the impact of the QIP on caregiver satisfaction with pain control.
Main Methods:
- Prospective cohort study at a tertiary children's hospital.
- Implementation of a QIP to standardize non-narcotic analgesics and reduce narcotic volume.
- Postoperative caregiver follow-up calls to assess pain control and satisfaction.
Main Results:
- Narcotic prescriptions decreased from 47% to 27% post-QIP (P < .05).
- Prescribed narcotic volume significantly reduced (300 ± 150 mL to 180 ± 111 mL, P < .05).
- Caregiver satisfaction scores remained unchanged (4.37 ± 0.85 vs. 4.35 ± 1.0).
Conclusions:
- A standardized post-tonsillectomy pain protocol reduced narcotic prescriptions without negatively impacting caregiver satisfaction.
- Quality improvement initiatives can optimize pain management in pediatric surgery.
- Further standardization of postoperative pain regimens is warranted.
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