Children's Opioid Use at Home After Laparoscopic Appendectomy

Area of Science:

• Pediatric Surgery
• Pain Management
• Pharmacology

Background:

• Accurate pediatric home opioid requirement data is crucial for managing acute post-surgical pain.
• Current estimates rely on retrospective surveys, highlighting a need for more precise methods.
• Medication adherence technology (eCAP) was employed to track actual home opioid consumption.

Purpose of the Study:

• To detail pediatric pain management at home following laparoscopic appendectomy.
• To compare self-reported opioid analgesic use against eCAP data and returned pill counts.
• To assess the accuracy of different methods in quantifying post-operative opioid consumption.

Main Methods:

• A prospective, exploratory, and descriptive study design was utilized.
• 96 pediatric patients (10-17 years) undergoing laparoscopic appendectomy participated.
• Data collection involved 14-day self-report diaries and eCAP monitoring of prescribed opioid use.

Main Results:

• Patients received a mean of 15 ± 7.2 opioid pills; significant differences were found between pill count (6.6 ± 6.3) and self-report (5.6 ± 5.1) usage (p=0.004).
• Of dispensed pills, a substantial portion was returned (488) or missing (53.5), with only 167.5 used as prescribed.
• Opioid-naïve patients (72%) predominantly used opioids on weekends, indicated by eCAP-recorded bottle openings.

Conclusions:

• Medication adherence technology (eCAP) provides a more rigorous and accurate method for estimating pediatric opioid needs than self-reporting.
• eCAP aids in the early detection of potential opioid misuse in pediatric populations.
• Further rigorously designed studies are necessary to refine opioid prescribing guidelines for post-operative pediatric pain management.