Postoperative Opioid Prescribing Following Cleft Lip Repair in 1497 Patients

Area of Science:

• Pediatric Surgery
• Pain Management
• Pharmacology

Background:

• Postoperative opioid prescribing is a concern in pediatric surgery.
• Cleft lip repair (CLR) is a common pediatric surgical procedure.
• Understanding opioid utilization patterns after CLR is crucial for optimizing pain management and stewardship.

Purpose of the Study:

• To determine the frequency of postoperative opioid prescriptions in patients undergoing cleft lip repair (CLR).
• To identify factors associated with opioid prescribing at discharge following CLR.
• To inform opioid stewardship strategies in pediatric surgical care.

Main Methods:

• Utilized the 2023 National Surgical Quality Improvement Program for Pediatric (NSQIP-P) database.
• Identified patients undergoing CLR using Current Procedural Terminology (CPT) codes.
• Conducted univariable analysis to identify predictors of postoperative opioid prescription.

Main Results:

• 44.6% of patients received opioid prescriptions at discharge, most commonly oxycodone.
• Increased patient weight, American Society of Anesthesiologists (ASA) classification, longer anesthesia time, and older age were associated with opioid prescription.
• Opioid prescribing was not significantly associated with bilateral versus unilateral CLR or inpatient versus outpatient status.

Conclusions:

• Opioid stewardship is essential in pediatric care.
• Age, weight, anesthesia duration, and ASA classification are key predictors of opioid prescription after CLR.
• Further research is needed to understand pain contributors and optimize prescribing practices for pediatric CLR patients.