Post-surgery opioid prescriptions decline for children, teens
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Post-surgery opioid prescribing for children and teenagers declined between 2014 and 2019, with a sharp decline seen starting in late 2017, according to a study published in Pediatrics.
Co-author Tori N. Sutherland, MD, MPH, a member of the department of anesthesiology and clinical care at The Children’s Hospital of Philadelphia, discussed the research project in a video abstract accompanying the study online. Sutherland and colleagues had previously noted the steady decline in opioid prescriptions for common dental surgeries after the CDC updated its guidelines for chronic pain in 2016.
“While children who undergo common outpatient surgeries such as dental surgery and adenoidectomy are routinely prescribed opioids, evidence suggests that they should be used with discretion for procedures associated with mild to moderate pain,” Sutherland said in the video.
In the retrospective cohort study, Sutherland and colleagues used information from a private insurance database to analyze data from 2014 to 2019 on 124,249 children (median age, 7 years; 45% girls) aged younger than 18 years undergoing eight common pediatric surgeries: tonsillectomy, adenoidectomy, laparoscopic appendectomy, cholecystectomy, dental surgery, knee arthroscopy, circumcision and orchiopexy.
The study population included 43,487 adolescents (35.1% of the sample), 40,221 (32.5%) school-aged children and 40,541 (32.7%) children aged younger than 5 years.
Examining the first quarter of the study period compared with the last quarter, the researchers noted the percentage of opioid prescriptions filled after surgery decreased from 78.2% (95% CI, 76.3-80.1) to 48% (95% CI, 45.8-50.1) among adolescents, 53.9% (95% CI, 51.6-56.2) to 25.5% (95% CI, 23.5-27.5) among school-aged children, and 30.4% (95% CI, 28.6-32.2) to 11.5% (95% CI, 10.1-12.9) among preschool-aged children. They noted a rapid decline from late 2017 to 2019. The authors also found a similar trend in the quantity of opioids dispensed.
The study was limited by using a patient population from a private insurance claims database, according to the researchers. They also noted both the decline in quantity of opioids dispensed and opioid prescriptions filled differed by age group and type of surgery.
“Additional research is indicated to better understand the reasons underlying changes in patterns of opioid prescribing for children of different ages after surgery,” the researchers wrote.