Academic Journal
Multicenter Evaluation of Opioid Prescribing After Minimally Invasive Repair of Pectus Excavatum Before The 2024 American Academy of Pediatrics Guideline: Room to Improve.
| Τίτλος: | Multicenter Evaluation of Opioid Prescribing After Minimally Invasive Repair of Pectus Excavatum Before The 2024 American Academy of Pediatrics Guideline: Room to Improve. |
|---|---|
| Συγγραφείς: | Brierley SF; Division of Pediatric Surgery, Phoenix Children's, Phoenix, Arizona. Electronic address: sfbrierl@buffalo.edu., Scaife JH; Division of Pediatric Surgery, University of Utah, Salt Lake City, Utah., Clinker CE; Division of Pediatric Surgery, University of Utah, Salt Lake City, Utah., Acker SN; Division of Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado., Bain AP; Division of Pediatric Surgery, UT Southwestern Medical Center, Dallas, Texas., Barq RM; Division of Pediatric Surgery, Department of Surgery, Children's Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, California., Byrd E; Division of Pediatric Surgery, Doernbecher Children's Hospital, Portland, Oregon., Chao SD; Division of Pediatric Surgery, Lucile Packard Children's Hospital Stanford, Palo Alto, California., Diaz-Miron J; Division of Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado., Gopalan M; Division of Pediatric General and Thoracic Surgery, Department of Surgery, Seattle Children's Hospital, University of Washington, Seattle, Washington., Kelley-Quon LI; Division of Pediatric Surgery, Department of Surgery, Children's Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, California., Hare R; Division of Pediatric Surgery, Phoenix Children's, Phoenix, Arizona., Hyman SC; Division of Pediatric Surgery, Rady Children's Hospital San Diego, San Diego, California., Keller BA; Division of Pediatric Surgery, Rady Children's Hospital San Diego, San Diego, California., Kim S; Division of Pediatric Surgery, UCSF Benioff Children's Hospital, San Francisco, California., Mata C; Division of Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado., Munar DK; Division of Pediatric Surgery, UCSF Benioff Children's Hospital, San Francisco, California., Nicassio LN; Division of Pediatric Surgery, Phoenix Children's, Phoenix, Arizona., Pandya SR; Division of Pediatric Surgery, UT Southwestern Medical Center, Dallas, Texas., Rothstein DH; Division of Pediatric General and Thoracic Surgery, Department of Surgery, Seattle Children's Hospital, University of Washington, Seattle, Washington., Schwab ME; Division of Pediatric Surgery, Lucile Packard Children's Hospital Stanford, Palo Alto, California., Sun RC; Division of Pediatric Surgery, Doernbecher Children's Hospital, Portland, Oregon., Ostlie DJ; Division of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Russell KW; Division of Pediatric Surgery, University of Utah, Salt Lake City, Utah., Padilla B; Division of Pediatric Surgery, Phoenix Children's, Phoenix, Arizona. |
| Πηγή: | The Journal of surgical research [J Surg Res] 2026 Oct; Vol. 326, pp. 1003-1009. Date of Electronic Publication: 2026 Aug 24. |
| Τύπος έκδοσης: | Journal Article; Multicenter Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Academic Press Country of Publication: United States NLM ID: 0376340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-8673 (Electronic) Linking ISSN: 00224804 NLM ISO Abbreviation: J Surg Res Subsets: MEDLINE |
| Imprint Name(s): | Publication: New York, NY : Academic Press Original Publication: Philadelphia [etc.] |
| Ιατρικοί όροι (MeSH): | Funnel Chest*/surgery , Analgesics, Opioid*/therapeutic use , Postoperative Pain*/drug therapy , Postoperative Pain*/etiology , Practice Patterns, Physicians'*/statistics & numerical data , Practice Patterns, Physicians'*/standards , Pain Management*/standards , Pain Management*/methods , Pain Management*/statistics & numerical data, Minimally Invasive Surgical Procedures/adverse effects ; Guideline Adherence/statistics & numerical data ; Drug Prescriptions/statistics & numerical data ; Drug Prescriptions/standards ; Humans ; Female ; Retrospective Studies ; Adolescent ; Child ; Male ; Practice Guidelines as Topic ; United States ; Young Adult |
| Περίληψη: | Introduction: To better understand baseline prescribing patterns before the release of the American Academy of Pediatrics (AAP)'s 2024 clinical guidelines on opioid prescribing, we evaluated the degree to which discharge pain management practices following minimally invasive repair of pectus excavatum (MIRPE) aligned with AAP's recommendations across 10 children's hospitals. Methods: Patients aged ≤21 y who underwent MIRPE (January 2022 to October 2023) were retrospectively reviewed. Those who underwent MIRPE for recurrent disease or underwent concurrent procedure(s) at the time of repair were excluded. Descriptive statistics were used to summarize findings. Results: A total of 528 patients were analyzed. The median preoperative Haller Index was 4.5 (interquartile range [IQR] 3.8, 5.7) and Correction Index was 33.0% (IQR 26.2%, 43.2%). One bar was placed in 50% of patients, two bars in 47.5% of patients, and three bars in 2.5% of patients. Cryoablation was used in 90% of patients, and 3.6% received subcutaneous pain pumps. The median hospital length of stay was 1 d (IQR 1.0, 2.0). Nearly all patients were discharged with nonopioid analgesics: acetaminophen (98.9%), nonsteroidal anti-inflammatory drugs (97.9%); 31.8% were prescribed gabapentin. Opioids were prescribed for 494 (93.6%) patients, with 95.5% of prescriptions written for fewer than 5 d. No patients received tramadol, codeine, opioid monotherapy, or long-acting opioids. Naloxone was prescribed for 37 (7.0%) patients. Co-prescription of opioids with benzodiazepines and/or muscle relaxants occurred in 79.7% of cases. Conclusions: Baseline discharge analgesic prescribing practices following MIRPE only partially aligned with AAP's guidelines. Opportunities for improvement include prescribing naloxone with opioids and reduction in co-prescription of sedating medications. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Keywords: Minimally invasive repair of pectus excavatum (MIRPE); Opioid stewardship; Pediatric surgery; Postoperative discharge medications |
| Substance Nomenclature: | 0 (Analgesics, Opioid) |
| Entry Date(s): | Date Created: 20260824 Date Completed: 20261008 Latest Revision: 20261013 |
| Update Code: | 20261014 |
| DOI: | 10.1016/j.jss.2026.07.049 |
| PMID: | 42636556 |
| Βάση Δεδομένων: | MEDLINE |
καταχωρήστε σχόλιο πρώτοι!