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Limited use of nonopioid analgesics after pediatric ambulatory surgery

Nhi Ho, MD, Anjali A. Dixit, MD, MPH, Christina Inglis-Arkell, MD, Solmaz P. Manuel, MD

Abstract


Objective: This study sought to determine the rate at which nonopioid analgesics were utilized in postoperative pain management plans after pediatric ambulatory surgery in patients who were also prescribed postoperative opioids.

Design: Retrospective cohort analysis.

Participants: Patients 21 years old who were prescribed opioid medications after undergoing ambulatory surgery at a tertiary-care medical center.

Methods: Postoperative day 1 (POD1) opioid prescription and use survey data along with electronic medical record data were extracted and analyzed for patients meeting inclusion criteria between April 2017 and December 2017.

Main outcome measure: Recommendation to take nonopioid analgesics after discharge.

Results: A total of 849 (63.2 percent) patients responded to the survey and 275 (32.4 percent) of these cases were prescribed postoperative opioids. Of the 273 cases included in this study, 137 (50.2 percent) received recommendations to take at least one nonopioid analgesic as well, and 164 (60.1 percent) reported using their prescribed opioids on POD1. Opioid use did not vary significantly with nonopioid analgesic recommendations. There was significant variability in opioid and nonopioid analgesic prescribing and recommendation patterns across surgical subspecialties.

Conclusions: There was limited use of nonopioid analgesics in postoperative pain management plans after pediatric ambulatory surgery. This leaves many patients with only opioid-based agents as the first-line medication for postoperative pain management. These findings highlight an opportunity to educate prescribers and patients on the importance of step-wise multimodal analgesic plans.


Keywords


pediatric surgery, postoperative pain, opioid, nonopioid analgesia, multimodal analgesia

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References


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DOI: https://doi.org/10.5055/jom.2021.0620

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