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Use of 2 National Registries to Identify Opioid Stewardship Opportunities in Children's Surgery

Anoosha Moturu1,2, Mallory Perez3, Willemijn Schäfer3

  • 1Division of Research and Optimal Surgical Care, American College of Surgeons, Chicago, IL.

Journal of the American College of Surgeons
|June 23, 2026
PubMed

Insights

Pediatric opioid prescribing after surgery is concentrated in specific procedures, showing significant hospital variation. These findings highlight targeted opportunities for improving opioid stewardship in children.

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Public Health

Background:

  • Pediatric postoperative opioid prescribing is a significant source of harm.
  • National prescribing patterns and hospital variability are not well-defined.
  • Targeted stewardship initiatives are needed.

Purpose of the Study:

  • To define national pediatric postoperative opioid prescribing patterns.
  • To identify inter-hospital variability in prescribing practices.
  • To pinpoint high-yield targets for opioid stewardship.

Main Methods:

  • Retrospective cohort study using NSQIP-Ped and PHIS data (2023).
  • Included non-neonate children (0-17 years) undergoing surgery.
  • Analyzed Opioid Prescription Proportion (OPP), Prescribing Practice Variability (PPV), and Contribution to Total Opioid Prescriptions (CTOP).

Main Results:

  • 31% of pediatric surgical cases received opioid prescriptions at discharge.
  • Top 20 procedures accounted for 95% of total opioid prescriptions.
  • Highest prescribing rates were for chest wall, lower extremity, and spine procedures.

Conclusions:

  • Pediatric opioid prescribing is concentrated in a few procedure groups.
  • Substantial hospital variation exists for specific procedures.
  • Data identify procedure-specific opportunities for opioid stewardship in pediatric surgery.
Abstract

Keywords:
Children’s surgeryNSQIP-POpioid stewardshipPHISPractice variation

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