Enhanced Recovery After Surgery Protocols Can Vastly Decrease Rates of Outpatient Opiate Prescribing in Pediatric...

Area of Science:

• Pediatric Surgery
• Pain Management
• Public Health

Background:

• Opioid prescribing in pediatric plastic surgery presents a significant public health concern.
• Enhanced Recovery After Surgery (ERAS) protocols aim to optimize surgical patient recovery.
• Non-opioid multimodal analgesia is a key component of ERAS protocols.

Purpose of the Study:

• To analyze and compare outpatient opioid prescribing rates in pediatric plastic surgery.
• To evaluate the impact of ERAS protocol implementation on opioid prescribing.
• To compare institutional rates with national averages.

Main Methods:

• Retrospective analysis of the 2023 ACS NSQIP Pediatric Opioid Stewardship Report.
• Inclusion of pediatric patients undergoing common plastic surgery procedures.
• Comparison of prescribing rates between an institution with ERAS protocols and national data.

Main Results:

• The study institution demonstrated significantly lower outpatient opioid prescribing rates (10.96%) compared to the national average (51.81%).
• Reductions were observed across all pediatric age groups, including adolescents, children, and infants.
• No neonates at the study site received outpatient opioids, contrasting with national rates.

Conclusions:

• Implementation of ERAS protocols is strongly associated with reduced outpatient opioid prescribing in pediatric plastic surgery.
• ERAS protocols offer an effective strategy for improving opioid stewardship.
• Wider adoption of ERAS protocols could enhance pain management and reduce opioid dependency in pediatric surgical patients.