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Opioid stewardship program implementation in pediatric surgeries: A systematic review

Ahmed H Mahmoud1, Rayan Muawad1, Plino S Ruiz1

  • 1Department of Pediatric Anesthesia, King Abdullah Specialist Children Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.

Saudi Journal of Anaesthesia
|April 23, 2026
PubMed

Insights

Opioid stewardship programs (OSPs) effectively reduce opioid prescribing in pediatric surgery without compromising pain control. These initiatives decrease risks of dependence and misuse in young patients.

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Public Health

Background:

  • Postoperative opioid use in children poses risks like dependence and misuse.
  • Opioid stewardship programs (OSPs) aim to improve prescribing and pain management.

Purpose of the Study:

  • Evaluate the effectiveness of OSPs in pediatric surgery.
  • Assess OSP impact on opioid prescribing practices.

Main Methods:

  • Systematic search of multiple databases (PubMed, MEDLINE, Embase, etc.) for studies from 2011-2024.
  • Included RCTs, observational studies, and systematic reviews focusing on pediatric surgery OSPs.
  • Rigorous data extraction and risk of bias assessment by multiple reviewers.

Main Results:

  • Eighteen studies involving over 83,000 patients were analyzed.
  • Interventions included prescribing protocols, guidelines, and provider education.
  • Significant reduction in opioid prescribing rates (68.4% to 10.7%) with stable pain scores and reduced oversedation.

Conclusions:

  • Structured OSPs, including protocols and education, effectively reduce pediatric opioid use.
  • Multimodal pain strategies are key to preserving adequate pain control.
  • Further multicenter trials are needed to optimize OSP interventions and patient outcomes.
Abstract

Keywords:
Analgesiaanesthesiaopioidspain managementstewardship

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