Eliminating Unnecessary Opioid Exposure After Common Children’s Surgeries | Pediatrics | JAMA Surgery | JAMA Network
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    Research Letter
    September 4, 2019

    Eliminating Unnecessary Opioid Exposure After Common Children’s Surgeries

    Author Affiliations
    • 1Michigan Opioid Prescribing Engagement Network, University of Michigan, Ann Arbor
    • 2Department of Surgery, Michigan Medicine, Ann Arbor
    • 3Division of Pediatric Urology, Department of Urology, Michigan Medicine, Ann Arbor
    • 4Section of Pediatric Orthopaedic Surgery, Department of Orthopaedic Surgery, Michigan Medicine, Ann Arbor
    • 5Division of Pediatric Otolaryngology, Department of Otolaryngology–Head and Neck Surgery, Michigan Medicine, Ann Arbor,
    • 6Section of Pediatric Surgery, Department of Surgery, Michigan Medicine, Ann Arbor
    JAMA Surg. 2019;154(12):1154-1155. doi:10.1001/jamasurg.2019.2529

    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

    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.