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Pediatric Surgical Opioid Prescribing by Procedure, 2020-2021

Kao-Ping Chua1, Chad M Brummett2,3, Lorraine I Kelley-Quon4,5

  • 1Susan B. Meister Child Health Evaluation and Research Center, and Departments of Pediatrics.

Pediatrics
|June 26, 2024
PubMed

Insights

Pediatric surgical opioid prescribing is concentrated in a few procedures, notably tonsillectomy and adenoidectomy. Targeting these common surgeries can reduce overall opioid use in children and adolescents.

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Opioid Stewardship

Background:

  • Surgery is a primary reason for prescribing opioids to pediatric patients.
  • Understanding which surgical procedures drive opioid prescribing is crucial for targeted interventions.

Purpose of the Study:

  • To identify specific surgical procedures associated with the highest pediatric opioid prescribing.
  • To analyze opioid prescribing patterns in different age groups within the pediatric population.

Main Methods:

  • Cross-sectional analysis of commercial and Medicaid claims (2020-2021).
  • Included surgical procedures for patients aged 0-21 years.
  • Calculated total opioid prescriptions in morphine milligram equivalents (MMEs) within 3 days of discharge.

Main Results:

  • For younger children (0-11 years), tonsillectomy/adenoidectomy accounted for 50.3% of post-surgical MMEs.
  • In adolescents (12-21 years), tonsillectomy/adenoidectomy (12.7%), knee arthroscopy (12.6%), and cesarean delivery (7.8%) were top procedures.
  • Top 3 procedures accounted for over 59% of MMEs in younger children and 33% in adolescents.

Conclusions:

  • Pediatric surgical opioid prescribing is highly concentrated among a limited number of procedures.
  • Opioid stewardship initiatives focused on these high-prescribing procedures can effectively reduce pediatric opioid exposure.
  • This targeted approach aims to minimize opioid risks while ensuring adequate pain management post-surgery.
Abstract

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