Our Summary

This research paper investigates the prescribing habits of general and pediatric surgeons when it comes to the use of opioids for pain relief in young patients undergoing appendectomy (a common surgery to remove the appendix). It is a known fact that adolescents who use prescription opioids are at a higher risk of drug abuse and overdose. The study looked at data from four hospitals and analyzed 336 cases of uncomplicated laparoscopic appendectomies (a less invasive surgical procedure) performed on patients aged 7-20 between 2016 and 2017. The main outcome evaluated was the amount of opioid prescribed after surgery.

The results showed that general surgeons prescribed significantly more opioids to adolescent patients than pediatric surgeons. For patients under 13, there was no significant difference in opioid prescription between the two types of surgeons. However, for the age group 13-20, pediatric surgeons prescribed 25% less opioid than general surgeons.

The study also found that being treated by a general surgery service was associated with higher opioid prescription, while having Medicaid was associated with lower prescription amounts.

In simple terms, the study suggests that there’s a need for more education and clear guidelines about opioid prescription for adolescents and young adults, especially among surgeons who do not often treat younger patients. This could potentially help reduce the risk of opioid abuse and overdose in these patients.

FAQs

  1. What was the main goal of the research paper on pediatric appendectomy?
  2. What were the main findings of the study regarding opioid prescriptions for young patients undergoing appendectomy?
  3. How could the risk of opioid abuse and overdose among young patients be reduced according to the study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric appendectomy is to discuss pain management options with the surgeon before the surgery. It is important to understand the risks and benefits of using opioids for pain relief and to work together to develop a plan that minimizes the risk of opioid misuse. Additionally, following the surgeon’s instructions for pain management after surgery and properly disposing of any leftover opioids can help prevent misuse and overdose.

Suitable For

Overall, patients who are typically recommended pediatric appendectomy are those who are between the ages of 7-20 and require surgery to remove their appendix. The study did not specify any particular types of patients within this age range, but it did highlight the importance of proper opioid prescribing practices for young patients undergoing surgery.

Timeline

Before pediatric appendectomy:

  1. Patient experiences symptoms of appendicitis such as abdominal pain, nausea, and vomiting.
  2. Patient undergoes diagnostic tests such as physical examination, blood tests, and imaging studies like ultrasound or CT scan.
  3. Appendicitis diagnosis is confirmed and surgery is recommended.
  4. Patient and family are educated about the surgery, risks, and post-operative care.

After pediatric appendectomy:

  1. Patient undergoes laparoscopic appendectomy surgery to remove the inflamed appendix.
  2. Patient is monitored in the recovery room and then transferred to a hospital room for further observation.
  3. Patient may experience pain and discomfort post-operatively, which is managed with pain medication.
  4. Patient is discharged from the hospital once they are stable and able to tolerate oral intake.
  5. Patient is advised on wound care, activity restrictions, and follow-up appointments.
  6. Patient may experience a full recovery within a few weeks and can resume normal activities.

What to Ask Your Doctor

Some questions a patient should ask their doctor about pediatric appendectomy:

  1. How much pain relief medication will be prescribed after the surgery and what type of medication will it be?
  2. What are the potential risks and side effects of the pain relief medication prescribed?
  3. Are there alternative pain management options that do not involve opioids?
  4. How long should I expect to be in pain after the surgery and how will it be managed?
  5. What steps are being taken to ensure that opioid medication is being prescribed responsibly and in appropriate amounts?
  6. Are there any non-pharmacological pain management techniques that can be used in addition to medication?
  7. How will my child’s pain be monitored and managed during the recovery process?
  8. What should I do if my child experiences severe or long-lasting pain after the surgery?
  9. Are there any signs or symptoms of opioid misuse or addiction that I should be aware of?
  10. How can we work together to ensure a safe and effective pain management plan for my child after the appendectomy surgery?

Reference

Authors: Freedman-Weiss MR, Chiu AS, Solomon DG, Christison-Lagay ER, Ozgediz DE, Cowles RA, Caty MG, Stitelman DH. Journal: J Surg Res. 2019 Mar;235:404-409. doi: 10.1016/j.jss.2018.09.085. Epub 2018 Nov 16. PMID: 30691822