Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University, 660 S. Euclid Avenue Campus Box 8238, St. Louis, MO, USA 63110.
Department of Surgery, Division of Transplant Surgery, Mayo Clinic, 1216 2nd Street SW, Rochester, MN, USA 55902.
J Plast Reconstr Aesthet Surg. 2022 Oct;75(10):3845-3852. doi: 10.1016/j.bjps.2022.06.064. Epub 2022 Jun 22.
The opioid abuse crisis is rampant in the United States. Children and adolescents are unique risk groups in this crisis; age-specific concerns include accidental ingestion and association with high-risk behaviors. Studies aimed at disposal are limited in pediatric patients. Our study aimed to determine whether an educational brochure detailing a simple opioid disposal method using dish soap could enhance disposal in postoperative pediatric patients.
A prospective survey study of pediatric plastic surgery patients at the St. Louis Children's Hospital was performed from January to December 2020. Patients were assigned into two groups: those who received the educational brochure at the time of surgery and those who did not. In clinic, patient caretakers completed anonymous preoperative and/or postoperative surveys regarding opioid use and disposal.
Surveys of 326 patients were analyzed (188 preoperative, 120 pre/postoperative, and 18 postoperative). Prescribed opioids were all consumed in 19% of patients. Receiving the educational brochure significantly increased the opioid disposal of leftover medications: 78% versus 35% (OR 6.52, 95% CI [2.03, 21.37], p < 0.001). Although not statistically significant owing to small sample size (p = 0.09), 71.4% of families with excess opioids in the home preoperatively retained unused postoperative opioids versus 31.6% without preoperative opioids.
Postoperative opioids are overprescribed for most pediatric plastic surgery patients. A simple brochure significantly increases proper postoperative opioid disposal, representing a cost-effective, convenient, risk-free method to decrease opioid misuse and accumulation in our communities.
阿片类药物滥用危机在美国肆虐。儿童和青少年是这一危机中的独特高风险群体;特定于年龄的关注点包括意外摄入和与高风险行为有关。针对处置问题的研究在儿科患者中有限。我们的研究旨在确定一份详细说明使用洗碗皂进行简单阿片类药物处置方法的教育手册是否可以增强术后儿科患者的处置能力。
对 2020 年 1 月至 12 月期间在圣路易斯儿童医院进行的小儿整形外科患者进行了前瞻性调查研究。患者被分为两组:一组在手术时收到教育手册,另一组则没有。在诊所,患者照顾者在术前和/或术后完成关于阿片类药物使用和处置的匿名调查。
对 326 名患者的调查进行了分析(188 名术前,120 名术前/术后,18 名术后)。19%的患者服用了所有开处的阿片类药物。接受教育手册显著增加了剩余药物的阿片类药物处置率:78%对 35%(OR 6.52,95%CI [2.03, 21.37],p < 0.001)。由于样本量小(p=0.09),虽然没有统计学意义,但术前家中有多余阿片类药物的家庭中,71.4%保留了未使用的术后阿片类药物,而没有术前阿片类药物的家庭中这一比例为 31.6%。
大多数小儿整形外科患者的术后阿片类药物处方过度。简单的手册显著增加了适当的术后阿片类药物处置,代表了一种经济有效、方便、无风险的方法,可以减少我们社区中的阿片类药物滥用和积累。