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Opioid use in postoperative pain management of pediatric appendectomy patients in Japan

Julia Smith Cavalcante1, Susumu Kunisawa1, Kiyohide Fushimi2

  • 1Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.

Journal of Anesthesia
|June 14, 2025
PubMed

Insights

Postoperative opioid use in pediatric appendectomy patients in Japan was low at 9.47%, with significant hospital variation observed. This suggests a need for evidence-based guidelines to ensure appropriate pain management and minimize opioid exposure.

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Health Services Research

Background:

  • Postoperative pain management in pediatric appendectomy is crucial.
  • Opioid analgesics are commonly used but carry risks.
  • Understanding patterns of opioid use in Japan is important for clinical practice.

Purpose of the Study:

  • To evaluate postoperative opioid analgesic use in pediatric appendectomy patients in Japan.
  • To investigate individual and facility-related factors influencing opioid use.
  • To compare Japanese opioid use rates with international data.

Main Methods:

  • Retrospective cohort study using Diagnosis Procedure Combination database.
  • Included 11,346 pediatric patients (2-18 years) undergoing appendectomy (2018-2020).
  • Outcome measured was the proportion of patients using postoperative opioids (POAP).

Main Results:

  • Overall POAP was 9.47%, lower than in other countries.
  • Higher POAP observed in patients with longer length of stay and abscesses.
  • Significant inter-hospital variation in opioid administration was noted.

Conclusions:

  • Japanese POAP rates are lower, potentially due to legislation and culture.
  • Hospital variation suggests a lack of standardized guidelines and physician preferences.
  • Development of evidence-based guidelines is needed to optimize pediatric opioid use.
Abstract

Keywords:
AppendectomyJapanOpioid analgesicPediatric surgeryPostoperative pain management

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