Opioid Prescribing and Use After Pediatric Umbilical Hernia Repair

Am Surg. 2021 Feb;87(2):296-299. doi: 10.1177/0003134820947388. Epub 2020 Sep 15.

Abstract

Background: Opioid overuse is a concern in adult and pediatric populations. Physician education may improve appropriate opioid prescribing and patient instruction for use. Prescribing and use of opioids for pain control after pediatric umbilical hernia (UH) repair before and after surgeon education was evaluated. This is a substudy of a multi-institutional study assessing prescribing practice before and after surgeon education. This study further assessed patient prescription filling patterns and parent report of pain control.

Methods: A retrospective study was performed evaluating children who underwent UH 6 months before and after an educational presentation on opioid use. Prescriptions, prescription fills, patient medication use, and pain control effectiveness were assessed. Adverse events were collected.

Results: There were 78 subjects in the pre-education and 99 in the post-education group. Opioid prescribed changed from 98.7% to 61.6% (P < .0001), and nonopioid prescriptions increased following education (P = .0063). The number of opioid prescriptions filled decreased (P = .0296). There were limited data on opioid doses used and quality of pain control, but the post-education group showed good pain control. There was no difference in adverse events.

Discussion: Surgeon education on the current opioid epidemic and strategies for opioid stewardship improves opioid prescribing and use without adversely impacting pain control or clinical outcome.

Keywords: narcotic; opioid stewardship; umbilical hernia repair.

MeSH terms

  • Analgesics, Opioid / therapeutic use*
  • Child
  • Drug Utilization Review
  • Female
  • Hernia, Umbilical / surgery*
  • Humans
  • Male
  • Pain, Postoperative / drug therapy*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Retrospective Studies

Substances

  • Analgesics, Opioid