Opioid Prescribing Practices in Cleft Lip and Cleft Palate Reconstruction

Area of Science:

• Pediatric surgery
• Pain management
• Craniofacial anomalies

Background:

• There is no established consensus on opioid use for pediatric perioperative pain management after cleft lip/palate repair.
• Understanding current prescribing practices is crucial for optimizing pain control and minimizing opioid exposure in this population.

Purpose of the Study:

• To evaluate the current opioid prescribing patterns among surgeons specializing in cleft lip and palate repair.
• To identify factors influencing opioid prescription habits, including procedure type, patient age, and surgeon experience.

Main Methods:

• An anonymous survey was distributed to members of the American Cleft Palate-Craniofacial Association.
• The survey collected data on opioid prescribing patterns for cleft lip repair and palatoplasty, including patient demographics, admission status, and medication details.

Main Results:

• Opioids are more frequently prescribed for inpatient palatoplasty than cleft lip repair. Oxycodone is the most common narcotic, typically for 1-3 days.
• Surgeons with over 15 years of experience are less likely to prescribe opioids. Most surgeons (92%) also prescribe non-opioid analgesics, primarily acetaminophen.
• Changes in prescribing over a surgeon's career generally involve decreasing both the dose and duration of opioid use.

Conclusions:

• Cleft surgeons primarily prescribe opioids for inpatients and infrequently upon discharge.
• Opioid prescribing patterns have shifted towards decreased dose and duration, with a significant use of non-opioid analgesics.