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Updated: Oct 11, 2025
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An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
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Opioid Reduction Through Postoperative Pain Management in Pediatric Orthopedic Surgery
Kerwyn Jones1, Laurie Engler2, Elizabeth Fonte1
1Departments of Orthopedic Surgery.
Pediatrics
|December 1, 2021
Summary
Standardized pediatric orthopedic pain guidelines significantly reduced opioid prescriptions by 54% post-surgery. This initiative maintained effective pain management without increasing unintended opioid refills.
Area of Science:
- Pediatric Orthopedics
- Pain Management
- Pharmacology
Background:
- Inconsistent opioid prescribing practices for pediatric orthopedic surgery.
- Need for standardized guidelines to optimize pain management and reduce opioid use.
Purpose of the Study:
- To reduce discharge opioid prescriptions for pediatric orthopedic patients.
- To maintain optimal pain management using standardized prescribing guidelines.
Main Methods:
- Developed a 4-tiered guideline for pediatric orthopedic postoperative pain management.
- Implemented an electronic medical record order set using the Model for Improvement methodology.
- Monitored provider compliance and opioid dosage (morphine milligram equivalents [MME]) over time.
Main Results:
- Achieved and sustained >90% compliance with guidelines for 20 months.
- Reduced opioid prescriptions by 54% (71 MME to 33 MME per patient).
- Maintained effective pain management with no significant change in unanticipated opioid refills (3% pre- and post-intervention).
Conclusions:
- Standardized guidelines significantly reduced pediatric orthopedic opioid prescribing.
- Effective postoperative pain management was maintained post-guideline implementation.
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