Pediatric Adenotonsillectomy Opioid Prescriptions Before and After Practice Guidelines and American Academy of Pediatrics Challenge.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY Otolaryngology- Head and Neck Surgery Pub Date : 2024-11-04 DOI:10.1002/ohn.1048

Najm S Khan, David Z Allen, Yin Yiu, Omar G Ahmed, Masayoshi Takashima, Zi Y Jiang

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Abstract

The opioid epidemic continues to concern the CDC and public health officials but recent trends in opioid prescribing rates following common pediatric otolaryngology surgeries are unexplored. This retrospective cohort study queried the TriNetX Research database from January 1, 2010, through December 31, 2023, for pediatric patients who underwent tonsillectomy and/or adenoidectomy and received oral opioids within 5 days of surgery. Prescription trends from 2010 to 2017 were compared to 2022 to 2023, after the publication of multiple clinical practice guidelines (CPGs). Of 286,572 surgeries, 29% of patients received postoperative opioids. Comparing the 2 time periods, a significant decrease was observed in the risk of postoperative opioid prescriptions following 2022 (RR 0.87, CI_95% 0.86-0.88). Prescribing rates decreased between 2018 and 2023 from 34% to 24%. Publication of CPGs were associated with a decrease in opioid prescribing rates and may have contributed to an encouraging trend in opioid stewardship.

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小儿腺扁桃体切除术阿片类药物处方前后的实践指南和美国儿科学会的挑战。

阿片类药物的流行继续引起美国疾病预防控制中心和公共卫生官员的关注，但常见儿科耳鼻喉科手术后阿片类药物处方率的最新趋势尚未得到探讨。这项回顾性队列研究查询了 TriNetX Research 数据库中 2010 年 1 月 1 日至 2023 年 12 月 31 日期间接受扁桃体切除术和/或腺样体切除术并在术后 5 天内口服阿片类药物的儿科患者。将 2010 年至 2017 年的处方趋势与 2022 年至 2023 年的趋势进行了比较，后者是多项临床实践指南 (CPG) 发布之后的趋势。在 286,572 例手术中，29% 的患者在术后接受了阿片类药物治疗。比较两个时间段，发现2022年之后术后阿片类药物处方风险显著下降（RR 0.87，CI95% 0.86-0.88）。2018年至2023年期间，处方率从34%降至24%。CPG的发布与阿片类药物处方率的下降有关，可能有助于阿片类药物管理方面令人鼓舞的趋势。

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来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.