Hospital Unit Variation in Pediatric Postoperative Opioid Administration Is Associated With Increased Neonatal Opioid...

Area of Science:

• Pediatric Surgery
• Neonatal Care
• Pharmacology

Background:

• Opioid stewardship is crucial in pediatric surgical care.
• The extent of opioid use in infants undergoing common procedures is not well-defined.
• Variations in opioid administration across hospital units require investigation.

Purpose of the Study:

• To compare opioid administration patterns in infants after laparoscopic gastrostomy tube placement.
• To assess differences in opioid use between neonatal intensive care unit (NICU) and pediatric ward patients.
• To evaluate intraoperative and postoperative opioid exposure.

Main Methods:

• Retrospective review of patients undergoing laparoscopic gastrostomy tube placement (2021-2023).
• Inclusion of pediatric and neonatal patients from a single children's hospital.
• Tracking of opioid exposure in morphine milligram equivalents per kilogram (MME/kg) intraoperatively and for 48 hours postoperatively.

Main Results:

• A total of 158 ward and 51 NICU patients were analyzed.
• Intraoperative opioid use (MME/kg) did not differ significantly between NICU and ward patients.
• Postoperative opioid use, administrations, and exposure time were significantly higher in NICU patients compared to ward patients, even in infants under 12 months.

Conclusions:

• NICU patients exhibit significantly higher postoperative opioid use following identical surgeries compared to pediatric ward patients.
• Further research is necessary to identify the reasons for this disparity.
• Optimizing opioid stewardship and reducing inter-unit variation in care are essential.