Related Experiment Video
Updated: Aug 12, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Opioids and pediatric urology: A prospective study evaluating prescribing habits and patient postoperative pain and
Tomas Lence1, Robert Thinnes1, Alexander J Foster1
1University of Iowa Hospitals & Clinics, Department of Urology, USA.
Insights
Pediatric urology patients experienced low pain and opioid consumption after surgery. However, the study found that opioids were consistently overprescribed, indicating a need for better pain management strategies.
Area of Science:
- Pediatric Urology
- Pain Management
- Pharmacology
Background:
- Opioid overprescription in pediatric surgery is a concern.
- Understanding postoperative pain and analgesia is crucial for optimizing pain management and reducing excess opioid use in pediatric urology patients.
Purpose of the Study:
- To assess postoperative pain levels in pediatric urology patients.
- To identify factors correlating with pain and opioid consumption.
- To determine which patients do not require opioids post-surgery.
Main Methods:
- Prospective cohort study involving 165 pediatric patients undergoing common urologic procedures.
- Postoperative pain and medication use were tracked for 7 days using text message-based questionnaires.
Main Results:
- Pain scores and opioid consumption were generally low across all procedure types (circumcision, inguinal hernia repair, orchidopexy, hypospadias repair).
- Opioid prescriptions significantly exceeded the actual amount consumed by patients in all surgical subgroups.
- Pain and opioid use peaked on postoperative day one and declined thereafter.
Conclusions:
- Postoperative pain and opioid requirements in pediatric urology patients are often lower than anticipated.
- Opioid medications are frequently overprescribed in pediatric urology, regardless of the specific procedure.
- Clinical practice should aim to align opioid prescribing with actual patient needs to prevent oversupply.
Introduction:
Few pediatric urologists believe patients require a majority of the doses of opioids prescribed to them postoperatively. Seeking a better understanding of postoperative pain and analgesia in pediatric urology patients may help reduce opioid over prescription while still adequately managing postoperative pain.
Objective:
We sought to better understand: 1) the postoperative pain levels experienced by pediatric urology patients, 2) the factors that correlate with postoperative pain and number of opioids consumed following pediatric urologic procedures, and 3) the patients who do not require opioids after surgery.
Study Design:
Pediatric patients undergoing circumcision, inguinal hernia repair, orchidopexy, or hypospadias repair were eligible to participate. Patients were enrolled in the prospective cohort on the day of the procedure. For each of the first 7 postoperative days, patients' parents completed a text message-based questionnaire, quantifying their child's pain level and the doses of pain medication the child consumed.
Results:
165 participants were enrolled. 57 patients underwent circumcision, 54 underwent orchiopexy, 32 underwent hypospadias repair, and 22 underwent inguinal hernia repair. For all procedure types, pain scores (p < 0.01) and doses of oxycodone consumed were highest on postoperative day one and steadily declined thereafter. Overall, average 7-day pain score (2.02; 0.86-5.14) and doses of narcotics consumed (3.50; 0-5) were low. Patients in each surgical subgroup were prescribed narcotics in excess of what was consumed. There was an average excess of 10.9 doses (0-39.0) for hypospadias repair, 8.6 (1.0-30.0) for circumcision, 9.0 (3.0-21.0) for inguinal hernia repair, and 6.1 (0-22.0) for orchiopexy.
Discussion:
Overall, reported pain scores and number of narcotics consumed were low regardless of surgery type. Opioids were overprescribed regardless of surgery type.
Conclusions:
Our findings indicate that level of pain and opioid use varies by procedure type, but that number of narcotics prescribed greatly exceeds number needed.
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
01:25Analgesia and Pain Management
01:02Prescription, Nonprescription and Orphan Drugs
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
01:22Opioid Receptors: Overview
01:15Drug Abuse and Addiction: Pharmacological Phenomena