Presentation Authors: Kelly Parker, Gwen Grimsby*, Phoenix, AZ
Introduction: The Center for Disease Control (CDC) reports that over 40 people die each day from opioid overdose. The amount of opioid prescriptions written in the United States has quadrupled since 1999. These numbers are staggering and show an alarming dependency and abuse of prescription pain medication in the United States. In the midst of this opioid epidemic, the CDC recommends that opioids not be first line therapy and that prescribers weigh the risks and benefits to their patients when prescribing a narcotic. The goal of this study was to evaluate narcotic use in a pediatric population after urologic surgery.
Methods: A short survey asking what medications were used after urologic surgery was given to family members of all patients to complete in private prior to a routine post-operative appointment. The survey asked if the patients received an opioid prescription, how many opioid doses were taken, and if the family had leftover medication. A retrospective review of the surveys was performed in addition to a retrospective chart review to collect basic demographic data including age at surgery, gender, and surgery type. Demographic factors were compared between patients who did and not use narcotics after surgery with t tests and Fisherâ€™s exact tests.
Results: 634 patients were included with a mean age of 5 years old (SD 6.18) with 96% being male. 388 patients (61%) were prescribed narcotics and 342 (55%) used narcotics after surgery. Out of the 39% of the population that were not prescribed a narcotic, only 7 (3%) parents felt their child should have had a narcotic. Patients used a mean of 4 doses of narcotics (SD 4.84) and 319 patients (93%) had leftover narcotics. Factors significantly associated with narcotic use included age >3 and hypospadias surgery. Factors significantly associated with not using narcotics included age < 3 and other penile and cystoscopic surgery, Table 1.
Conclusions: We have been overprescribing narcotics after urologic surgery. Based on the survey data we recommend that narcotics are only prescribed for patients >3 years old unless the patient had a hypospadias repair. In cases when narcotics are indicated it appears only 5 doses is adequate. By obtaining and analyzing our data we are able to make better decisions if a narcotic is needed and to prescribe the lowest effective dosage with shorter duration of treatment.