Reducing Postoperative Opioids in Pediatric Laparoscopic Cholecystectomy: A Retrospective, Single-Center Cohort Study.
Document Type
Article
Publication Date
2-2025
Identifier
DOI: 10.1016/j.jss.2024.12.028
Abstract
INTRODUCTION: Overprescribing of opioid pain medications can lead to adverse outcomes and contributes to the opioid crisis. We previously reported eliminating opioids in select patients. This retrospective study aimed to compare outcomes in pediatric patients undergoing laparoscopic cholecystectomy (LC) who were and were not prescribed opioid pain medications.
METHODS: A retrospective review of pediatric patientsdemographics, operative details, medication usage, and postoperative complications were recorded. Patients prescribed opioid pain medication at discharge were compared to those who were treated with nonopioid pain medications (i.e., acetaminophen, ibuprofen, and ketorolac).
RESULTS: In total, 511 patients were included, of which 76.9% were prescribed opioids. Patients who were not prescribed opioids more commonly received intravenous ketorolac (81.4% versus 35.6%, P < 0.001), used less postoperative morphine milligram equivalents per kilogram (MME) (0.3 versus 0.4 MME/kg, P = 0.044), had lower rates of postoperative phone calls for pain (6.8% versus 18.8%, P = 0.002), and reported less pain at follow-up (6.8% versus 18.8%, P = 0.002). There were no differences in emergency department visits or hospital readmissions within 30 ds of discharge. Institutional rates of opioid prescriptions following LC decreased over the study duration (97.8% in 2016 to 28.4% in 2022, P < 0.001).
CONCLUSIONS: Nonopioid postoperative pain control in pediatric patients undergoing LC is well-tolerated and may be effective in reducing opioid use. In this cohort, nonopioid and opioid pain management modalities had similar postoperative hospital resource utilization. Therefore, opioid use and its resultant complications may potentially be able to be reduced.
Journal Title
The Journal of surgical research
Volume
306
First Page
580
Last Page
587
MeSH Keywords
Humans; Retrospective Studies; Analgesics, Opioid; Cholecystectomy, Laparoscopic; Pain, Postoperative; Male; Female; Child; Adolescent; Analgesics, Non-Narcotic; Child, Preschool; Ketorolac; Practice Patterns, Physicians'; Pain Management; Acetaminophen
PubMed ID
39892302
Keywords
Laparoscopic cholecystectomy; Opioid prescribing; Opioid stewardship; Pediatric surgery; Postoperative outcomes
Recommended Citation
Marlor DR, Edmundson E, Cruz-Centeno N, et al. Reducing Postoperative Opioids in Pediatric Laparoscopic Cholecystectomy: A Retrospective, Single-Center Cohort Study. J Surg Res. 2025;306:580-587. doi:10.1016/j.jss.2024.12.028
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