Our Summary

This research paper discusses a study aimed at reducing the overuse of prescription opioids, particularly in children. The team examined the effects of educational interventions, such as staff education, a standardized opioid protocol, and educational materials for families. They compared the prescribing habits before and after the intervention for patients less than 19 years old who had undergone an appendectomy.

Before the intervention, 84.3% of these patients were given a prescription for opioids when they were discharged from the hospital. After the intervention, however, only 6.7% were given such a prescription. Instead, there was a significant increase in the use of non-opioid painkillers.

The study also found that the type of surgery, the doctor in charge, and the patient’s age or gender did not significantly affect opioid usage.

Follow-up calls were made to assess patient satisfaction and pain control. The majority of patients were given acetaminophen and/or ibuprofen instead of opioids, and most reported that their pain was well-controlled. Moreover, 88.9% said they would agree to avoid opioids in the future.

Importantly, the study found no increase in emergency room visits or phone calls due to poorly controlled pain after the intervention. This suggests that the educational interventions and standardized pathway were effective in reducing opioid prescriptions and promoting alternative pain management methods without increasing readmissions or pain-related issues.

FAQs

  1. What were the interventions used in the study to reduce the usage of prescription opioids in children?
  2. Did the reduction in opioid prescription after the intervention lead to an increase in emergency room visits or phone calls due to poorly controlled pain?
  3. How did the type of surgery, the doctor in charge, and the patient’s age or gender affect the usage of opioids in the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pediatric appendectomy is to discuss alternative pain management options, such as acetaminophen and ibuprofen, with their healthcare provider before surgery. It is important to communicate any concerns or preferences regarding pain medication to ensure the best possible outcome for the child.

Suitable For

Overall, pediatric patients who undergo an appendectomy are typically recommended non-opioid pain management options, such as acetaminophen and ibuprofen, over prescription opioids. This study highlights the importance of implementing educational interventions and standardized protocols to reduce the overuse of opioids in this patient population. By doing so, healthcare providers can effectively manage pain while minimizing the potential risks associated with opioid use, such as addiction and overdose.

Timeline

In summary, before a pediatric appendectomy, a patient may experience symptoms such as abdominal pain, nausea, vomiting, and fever. They may undergo diagnostic tests such as blood work, imaging studies, and possibly a physical exam to confirm the diagnosis of appendicitis. After the surgery, the patient will typically stay in the hospital for a few days for monitoring and recovery.

Before the intervention in the study, the majority of pediatric appendectomy patients were prescribed opioids for pain management upon discharge. However, after the educational interventions were implemented, there was a significant decrease in opioid prescriptions and an increase in the use of non-opioid painkillers. Follow-up calls showed that patients were satisfied with their pain control and would be willing to avoid opioids in the future. Importantly, there was no increase in emergency room visits or phone calls related to poorly controlled pain after the intervention.

What to Ask Your Doctor

  1. What are the potential risks and benefits of undergoing an appendectomy for my child?

  2. What are the specific reasons why my child needs to undergo an appendectomy?

  3. What is the expected recovery time for my child after the surgery?

  4. What are the potential complications that my child could experience during or after the surgery?

  5. What pain management options will be available for my child after the surgery?

  6. Will my child be prescribed opioids for pain management after the surgery? If so, what are the potential risks associated with opioid use in children?

  7. Are there alternative pain management options that can be used instead of opioids for my child?

  8. What steps will be taken to ensure that my child’s pain is effectively managed after the surgery?

  9. How will my child’s pain be monitored and assessed during the recovery period?

  10. Are there any specific guidelines or protocols in place to reduce the overuse of opioids in pediatric patients undergoing an appendectomy?

Reference

Authors: Cairo SB, Calabro KA, Bowdish E, Reilly C, Watt S, Rothstein DH. Journal: J Pediatr Surg. 2019 Sep;54(9):1866-1871. doi: 10.1016/j.jpedsurg.2018.11.015. Epub 2019 Feb 7. PMID: 30819545