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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
PubMed

Insights

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.
Abstract

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