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"Opioid-Free Hernia Repair Protocol Reduces Pediatric Opioid Exposure Without Compromising Pain Control"

Abigail Teitelbaum1, Kristin LeMarbe1, Diane Studzinski1

  • 1Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA.

Journal of Pediatric Surgery
|August 18, 2026
PubMed

Insights

A new protocol for pediatric hernia surgery significantly reduced opioid use by using regional anesthesia and non-opioid analgesics. This approach maintained pain control and patient satisfaction, supporting opioid-free pain management in children.

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Anesthesiology

Background:

  • Perioperative opioid exposure in children undergoing surgery is a concern.
  • Multimodal pain management strategies aim to reduce opioid dependence.
  • Protocolizing pain management is key to standardizing care and outcomes.

Purpose of the Study:

  • To design and evaluate a multimodal pain management protocol for pediatric ambulatory hernia surgery.
  • To assess the protocol's impact on opioid use.
  • To determine effects on pain control, patient satisfaction, and postoperative outcomes.

Main Methods:

  • A protocol incorporating child life services, regional anesthesia, and non-opioid analgesics was implemented.
  • Pediatric ambulatory hernia cases were reviewed two years before and after implementation.
  • Protocol adherence was stratified by opioid use; patient satisfaction and pain control were assessed via surveys.

Main Results:

  • Significant increases in regional anesthesia and non-opioid analgesic use were observed post-protocol.
  • Intraoperative and postoperative opioid use decreased significantly.
  • Opioid prescriptions at discharge dropped, while pain scores and patient satisfaction remained stable or improved.
  • Postoperative complication rates were similar between groups.

Conclusions:

  • The opioid-free pediatric hernia repair protocol effectively reduced perioperative opioid use.
  • Pain control, patient/proxy satisfaction, and postoperative outcomes were not compromised.
  • This supports the integration of opioid-free multimodal pain regimens in pediatric surgical settings.
Abstract

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