Opioid prescribing gradually declined for children and teens following surgeries between 2014 and 2017, and declined more rapidly beginning in 2017. This trend began after evidence emerged suggesting that recovery is similar with limited or no opioids. A study, “Trends in Routine Opioid Dispensing After Common Pediatric Surgeries in the United States: 2014–2019,” published in the May 2022 Pediatrics (published online April 4) observed that opioids have been routinely prescribed for common pediatric surgeries associated with mild to moderate pain. But in children, excessive postoperative opioid exposure has been associated with adverse outcomes such as respiratory depression and new long-term use. Researchers used information from a private insurance database to analyze data on 124,249 children undergoing eight common pediatric surgeries between 2014 to 2019. They found that prescribing first decreased gradually from 2014 through 2017, followed by a more rapid period of decline from late 2017 through 2019. Authors identified a similar trend in the amount of opioid prescribed. They also found that the distribution of common surgeries differed by age group. Among all children, the three most commonly performed surgeries were tonsillectomy, dental surgery and adenoidectomy. Among adolescents, the three most common procedures were knee arthroscopy, dental surgery and tonsillectomy. Over the course of the study, the percentage filling an opioid prescription after surgery decreased from 78.2% to 48.0% in teens, from 53.9% to 25.5% among school-age children, and from 30.4% to 11.5% among preschool children, according to the study findings. With regard to the amount of opioid dispensed to adolescents, the average amount declined from 228.9 to 110.8 morphine milligram equivalents (MME), equivalent to a decrease of 23.6 5-mg hydrocodone tablets. The authors suggest more research is needed to better understand the reasons underlying changes in patterns of opioid prescribing for children of different ages after surgery.
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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.