Factors Associated with Postoperative Opioid Use in Adolescents.
J Pediatr Surg
; 59(4): 709-717, 2024 Apr.
Article
em En
| MEDLINE
| ID: mdl-38097461
ABSTRACT
BACKGROUND:
We aimed to identify factors associated with postoperative prescription opioid use in adolescents.METHODS:
Adolescents aged 13-20 years undergoing surgery were prospectively recruited from a children's hospital. Adolescent-parent dyads completed a preoperative survey, measuring clinical and sociodemographic factors, and two postoperative surveys evaluating self-reported opioid use at 30- and 90-days. Poisson regression analysis identified factors associated with the number of pills used within 90-days, adjusting for age, gender, race/ethnicity, surgery type, and pain at discharge.RESULTS:
We enrolled 119 adolescents who reported postoperative opioid use following posterior spinal fusion (PSF) (50 %), arthroscopy (23 %), pectus excavatum repair (11 %), tonsillectomy (8 %), and hip reconstruction (7 %). Overall, 81 % of adolescents reported unused opioids. The median pain score at discharge was 7 (IQR5-8). Adolescents reported using a median of 7 (IQR2-15) opioid pills, with 20 (IQR7-30) pills left unused. Compared to all other surgeries, adolescents undergoing PSF reported the highest median pill use (10, IQR5-29; p = 0.004). Adolescents undergoing tonsillectomy reported the lowest median pill use (1, IQR0-7; p = 0.03). On regression analysis, older patient age was associated with a 12 % increase in pill use (95 % CI3%-23 %). Undergoing PSF was associated with a 63 % increase in pill use (95 % CI15%-31 %). Each additional pain scale point reported at discharge was associated with a 13 % increase in pill use (95 % CI5%-22 %).CONCLUSIONS:
Older age, surgery type, and patient-reported pain at discharge are associated with postoperative prescription opioid use in adolescents. Understanding patient and surgery-specific factors associated with opioid use may guide surgeons to minimize excess opioid prescribing. LEVEL OF EVIDENCE II.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos Torácicos
/
Analgésicos Opioides
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article