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Opioid Prescribing Trends After Major Pediatric Ear Surgery: A 12-Year Analysis

Holly Cordray1,2, John Galvin3, Addison Clark4

  • 1Children's Healthcare of Atlanta, Atlanta, Georgia, U.S.A.

The Laryngoscope
|September 2, 2022
PubMed

Insights

Opioid prescribing after pediatric ear surgery significantly decreased without impacting patient revisits. This suggests broader effects of quality improvement initiatives on opioid stewardship.

Area of Science:

  • Pediatric Otolaryngology
  • Pain Management
  • Public Health

Background:

  • Postoperative opioid prescriptions in children often exceed actual analgesic requirements.
  • Growing awareness of the opioid epidemic may influence prescribing practices.

Purpose of the Study:

  • To evaluate trends in opioid prescribing patterns following major pediatric ear surgery.
  • To assess the impact of prescribing changes on patient outcomes.

Main Methods:

  • Retrospective review of pediatric ear surgery cases (2010-2021).
  • Analysis of opioid prescribing rates, doses, and supply duration.
  • Regression analysis to identify prescribing trends and covariates.
  • Evaluation of patient return rates to the system.

Main Results:

  • Opioid prescribing rates significantly declined from a peak of 96.1% in 2012 to 13.5% in 2021.
  • Average doses per prescription decreased by 68%, with a shorter supply duration (3.1 days).
  • No significant change in pain-related patient returns was observed.
  • Prescribing trends correlated with a concurrent tonsillectomy quality improvement protocol.

Conclusions:

  • Surgeon-led opioid stewardship improved significantly for pediatric ear surgery patients.
  • Quality improvement interventions may have unintended positive impacts on prescribing behaviors beyond their primary target.
  • No adverse effect on patient revisit rates was detected.
Abstract

Keywords:
opioid analgesicsotolaryngologyotologypain managementpediatricspostoperative pain

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