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Variability and Excess in Opioid Prescribing Patterns After Cleft and Craniosynostosis Repairs

Ema Zubovic1, Gary B Skolnick1, Jacob D AuBuchon2

  • 1Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|February 28, 2022
PubMed

Insights

Pediatric opioid prescriptions after cleft and craniosynostosis repairs vary significantly. Most children use fewer opioids at home than prescribed, suggesting a need for updated prescribing guidelines.

Area of Science:

  • Pediatric surgery
  • Pain management
  • Pharmacology

Background:

  • Opioid prescriptions after pediatric craniofacial surgery exhibit wide variability.
  • Understanding actual opioid consumption is crucial for optimizing pain management and preventing misuse.

Purpose of the Study:

  • To analyze pediatric opioid prescription patterns following cleft and craniosynostosis repairs.
  • To compare prescribed opioid doses with actual patient opioid use at home.

Main Methods:

  • An observational study involving retrospective prescription review and prospective patient surveys.
  • Included 133 pediatric patients undergoing cleft lip/palate or craniosynostosis repairs.
  • Assessed opioid doses prescribed at discharge and actual home opioid consumption.

Main Results:

  • Median prescribed opioid doses were 10.3 for cleft lip/palate and 14.3 for craniosynostosis repairs.
  • A negative correlation was observed between age and prescribed opioids in cleft lip/palate patients (r = -0.228, p = 0.031).
  • Most surveyed patients (45) used five or fewer opioid doses at home, with 40% using none.

Conclusions:

  • Significant variation exists in opioid prescribing for pediatric craniofacial procedures.
  • Younger cleft lip/palate patients may receive higher opioid prescriptions.
  • Actual opioid use is generally lower than prescribed, supporting the development of standardized prescribing guidelines.
Abstract

Keywords:
Cleft Lip and Palate (CLP)craniosynostosisopioids

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