Variation in opioid utilization among neonates with gastroschisis

Area of Science:

• Neonatal surgery
• Pediatric pharmacology
• Pain management

Background:

• Neonates undergoing surgery face risks of neurocognitive delays from painful stimuli and early opioid exposure.
• Gastroschisis, a congenital abdominal wall defect, often requires surgical intervention and pain management.

Purpose of the Study:

• To investigate opioid utilization patterns in neonates diagnosed with gastroschisis.
• To identify factors influencing opioid use in this vulnerable population.

Main Methods:

• Retrospective review of 30 infants with gastroschisis treated between 2017-2019.
• Multivariate linear regression analysis to assess variations in opioid administration (measured in MME/kg).

Main Results:

• Morphine was the predominant opioid (89%), with a median use of 6.5 days.
• Surgical approach accounted for 45% of the variation in opioid use (p=0.02), particularly before fascial closure.
• Opioid use significantly decreased after definitive fascial closure.

Conclusions:

• Significant variability exists in opioid utilization among neonates with gastroschisis, primarily before surgical repair.
• Understanding and standardizing pain management strategies are crucial for improving opioid stewardship.
• Further research can optimize pain control and minimize long-term neurocognitive risks.