MP34-13 A PROSPECTIVE ANALYSIS OF OPIOID USE FOLLOWING OUTPATIENT PEDIATRIC UROLOGIC SURGERY

Abstract

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety II (MP34)1 Sep 2021MP34-13 A PROSPECTIVE ANALYSIS OF OPIOID USE FOLLOWING OUTPATIENT PEDIATRIC UROLOGIC SURGERY Rachael Sherrer, Ann Byrne, Fardod O'Kelly, Ruthie Su, and Walid Farhat Rachael SherrerRachael Sherrer More articles by this author , Ann ByrneAnn Byrne More articles by this author , Fardod O'KellyFardod O'Kelly More articles by this author , Ruthie SuRuthie Su More articles by this author , and Walid FarhatWalid Farhat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002043.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While opioids have a role in multimodal post-operative analgesia, there is increasing data which suggests they may not be routinely required after pediatric surgery. With this lack of consensus on opioid use after pediatric urologic procedures, we sought to examine impact of patient characteristics and surgery type on opioid usage in our outpatient urologic surgery cohort. METHODS: This prospective study was approved by the hospital’s Institutional Review Board. Opioid use data was prospectively collected over a 12-month period (January to December 2020) via routine institutional post-operative telephone calls to parents of patients undergoing outpatient urologic surgery. Patient characteristics (age, sex, race), surgery type, and opioid prescription and refill information were recorded. Those who underwent a simultaneous procedure with another specialty or were admitted to the hospital were excluded. All patients were prescribed scheduled acetaminophen and ibuprofen for 48 hours after surgery, then as needed, and up to a maximum of 5 doses of oxycodone. The count of opioid doses was modelled using negative binomial regression with robust standard errors. RESULTS: 263 patients underwent outpatient urologic surgery over the 12-month period. 182 predominantly male (99%) patients met inclusion criteria, with mean age of 5.1 years and mean 4.9 opioid doses prescribed per patient. There were 138 genital, 21 inguinal, 17 laparoscopic, and 6 cystoscopic procedures. Mean opioid use was one single dose, and 94 (52%) patients used no opioids. The mean number of excess, unused prescribed doses per patient was 4. Eleven patients used all doses prescribed, and one received a refill (5 additional doses). Table 1 outlines opioid use by surgery, age, and race. These were not independent predictors of opioid use on multivariable analysis, although there was a trend toward increased use in adolescents. CONCLUSIONS: Our findings suggest that opioids are in fact likely over-prescribed after outpatient pediatric urologic surgery, with 93% of patients not requiring all of their opioid prescription and 52% not using any opioids at all. While overall opioid requirements were low across all sub-cohorts, there was a trend toward increased use in adolescents which should be factored into education with this group. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e621-e621 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rachael Sherrer More articles by this author Ann Byrne More articles by this author Fardod O'Kelly More articles by this author Ruthie Su More articles by this author Walid Farhat More articles by this author Expand All Advertisement Loading ...