Department of Pediatric Surgery, University of Texas Health Science Center at Houston, Houston, TX; Center for Surgical Trials and Evidence-Based Practice (CSTEP), University of Texas Health Science Center at Houston, Houston, TX.
Department of Pediatric Surgery, University of Texas Health Science Center at Houston, Houston, TX.
Surgery. 2024 Oct;176(4):1222-1225. doi: 10.1016/j.surg.2024.06.035. Epub 2024 Jul 18.
Published guidelines to reduce the use and misuse of opioids in pediatrics are limited. After the implementation of an opioid stewardship program, we aimed to investigate the prescribing patterns in pediatric surgery.
A retrospective chart review of pediatric patients who underwent general pediatric surgery procedures at a single institution between July 2021 and July 2023 was conducted. Demographics, procedure details, and opioid prescriptions at discharge were collected. The Texas Prescription Monitoring Program was cross-referenced for prescription-filled data. Descriptive statistics were performed.
Of the 4,323 patients included, 9% (391) received an opioid prescription at the time of discharge. Among these, 82% were for burns, 7% for trauma, and 4% for pectus excavatum. Appendectomy, inguinal hernia repair, umbilical hernia repair, and circumcision did not receive any opioid prescriptions. In those who received a prescription, the median age was 4.2 years (interquartile range (IQR) 1.6, 10.4), with 58.6% being male. A total of 82.6% of patients also received prescriptions for nonopioid analgesics. The median number of prescribed doses was 13 (IQR 7, 15) for burns, 12 (IQR 9, 15) for trauma, and 12 (IQR 10, 12) for pectus excavatum. In total, 87% of prescriptions were filled.
A small proportion of pediatric patients who underwent general surgery received opioid prescriptions at the time of discharge and were limited to a few conditions. Common pediatric operations received no opioid prescriptions in the 2-year study period. A total of 13% of the written prescriptions were unfilled. Future studies are needed to optimize the target pediatric patient population for opioid prescribing.
已发布的减少儿科中阿片类药物使用和滥用的指南有限。在实施阿片类药物管理计划后，我们旨在调查小儿外科的处方模式。
对一家机构在 2021 年 7 月至 2023 年 7 月期间接受普通小儿外科手术的小儿患者进行回顾性病历审查。收集人口统计学资料、手术细节和出院时的阿片类药物处方。交叉参考德克萨斯州处方监测计划以获取处方填写数据。进行描述性统计分析。
在纳入的 4323 名患者中，9%（391 名）在出院时收到阿片类药物处方。其中，82%为烧伤，7%为创伤，4%为漏斗胸。阑尾切除术、腹股沟疝修补术、脐疝修补术和包皮环切术未开具任何阿片类药物处方。在接受处方的患者中，中位年龄为 4.2 岁（四分位距 (IQR) 1.6，10.4），男性占 58.6%。共有 82.6%的患者还开具了非阿片类镇痛药的处方。烧伤患者的处方规定剂量中位数为 13（IQR 7，15），创伤患者为 12（IQR 9，15），漏斗胸患者为 12（IQR 10，12）。总共有 87%的处方得到了填写。
少数接受普通外科手术的小儿患者在出院时收到阿片类药物处方，且仅限于几种情况。在为期 2 年的研究期间，常见的小儿手术未开具阿片类药物处方。书面处方的总共有 13%未被填写。需要进一步研究以优化阿片类药物处方的目标小儿患者人群。
