Pain management after pediatric adenotonsillectomy: Do opioids influence healthcare utilization?

Area of Science:

• Pediatric Surgery
• Pain Management
• Healthcare Utilization

Background:

• Adenotonsillectomy (AT) is a common pediatric outpatient surgery.
• Multimodal pain management is recommended to mitigate opioid risks.
• This study investigates healthcare utilization based on postoperative medication regimens.

Purpose of the Study:

• To assess healthcare utilization differences in pediatric AT patients based on their postoperative medication regimen.
• To analyze the impact of opioid versus non-opioid pain management on calls and emergency department (ED) visits.
• To explore potential correlations between medication, age groups, and race in relation to healthcare utilization.

Main Methods:

• Retrospective analysis of 699 pediatric patients (3-18 years) undergoing AT.
• Patients stratified into young children (3-4 years), children (5-12 years), and adolescents (≥13 years).
• Data collected on total calls, calls for pain/dehydration (P/D), and ED visits; medication regimens analyzed.

Main Results:

• No significant correlation between opioid prescriptions and calls or ED visits for P/D in patients aged 5 years and older.
• Young children (3-4 years) on non-opioid regimens showed a higher likelihood of any phone call (p=0.049).
• White patients had higher rates of phone calls (p=0.0183) and P/D-related calls (p<0.001); no racial differences in ED visits.

Conclusions:

• Reducing opioid prescriptions in pediatric AT patients does not appear to negatively impact overall healthcare utilization.
• Opioid use in young children was associated with fewer phone calls, though not specifically for P/D.
• Further prospective studies are needed to document pain scores and medication administration for optimal pain control optimization.