Eliminating Unnecessary Opioid Exposure After Common Children’s Surgeries

From 1999 to 2016, opioid-related overdoses rose by 250% among children and adolescents.1 Acute pain after surgery or injury is the most frequent indication for pediatric opioid prescribing.2 However, prescribing is variable, and little is known regarding patient-reported opioid consumption and pain after pediatric operations to guide opioid prescribing.3,4 Methods | As part of a multispecialty quality improvement project to reduce opioid prescribing, this study was deemed exempt by the University of Michigan institutional review board.Children younger than 18 years undergoing umbilical or epigastric herniorrhaphy; laparoscopic appendectomy; inguinal herniorrhaphy and/or hydrocelectomy; adenoidectomy; circumcision; percutaneous pinning for elbow fracture (supracondylar, epicondylar, or condylar); or scrotal-incision orchiopexy at a tertiary care facility were screened for eligibility (April 2018 to November 2018).Exclusion criteria were enrollment in another study, admission greater than 7 days, and any previous or concurrent operations during the study period.Caregivers received pain journals to record postoperative analgesic use.Caregivers were contacted at 7 to 21 days postoperatively by telephone, email, or follow-up appointment regarding pain control and analgesic use.Verbal consent was obtained prior to survey administration.Outpatient opioid prescriptions and emergency department (ED) visits within 30 days of discharge were collected from the electronic medical record.Number of doses was calculated as total quantity divided by minimum dose.Missing responses were excluded on