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Perioperative opioid use in paediatric inguinal hernia patients: A systematic review and retrospective audit of

Isabel C Hageman1, Melissa Y Tien2, Misel Trajanovska3

  • 1Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria 3052, Australia; Faculty of Medicine, Utrecht University, Utrecht, the Netherland.

Journal of Pediatric Surgery
|April 10, 2022
PubMed

Insights

Opioid prescribing for pediatric inguinal hernia surgery varies widely. At The Royal Children

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Pharmacology

Background:

  • Opioids are crucial for pediatric postoperative pain, yet their use is understudied.
  • This study investigates perioperative opioid prescribing for pediatric inguinal hernia patients.
  • Practices were examined in existing literature and at The Royal Children's Hospital (RCH).

Purpose of the Study:

  • To describe current opioid prescribing patterns for pediatric inguinal hernia repair.
  • To compare literature-based practices with institutional data from RCH.
  • To identify factors influencing opioid use in this patient population.

Main Methods:

  • A systematic review of English articles (2009-2019) on pediatric inguinal hernia patients receiving opioids.
  • A retrospective audit of 150 pediatric inguinal hernia patients at RCH.
  • Collection of demographic, surgical, and analgesic data from electronic medical records.

Main Results:

  • Fifteen studies (n=1166) showed wide variation in postoperative opioid use (3.33-100%).
  • At RCH, 17.3% of 150 patients received postoperative opioids, primarily fentanyl and oxycodone.
  • Older age, female sex, and lack of regional anesthesia correlated with increased opioid use; no discharge prescriptions were given.

Conclusions:

  • Significant variability exists in pediatric inguinal hernia opioid prescribing.
  • Opioid use in the postoperative period at RCH was infrequent.
  • Further research is needed to standardize safe and effective pediatric pain management.
Abstract

Keywords:
ChildrenInguinal herniaOpioidPainSurgery

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