Back to Search
Start Over
No pain is gain: A prospective evaluation of strict non-opioid pain control after pediatric appendectomy
- Source :
- Journal of Pediatric Surgery. 55:1043-1047
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Introduction Opiates are often prescribed after pediatric operations despite safety concerns and lack of evidence confirming superiority compared to other pain control modalities. In this study, we use daily parental surveys to prospectively evaluate a strict non-opioid pain control strategy after laparoscopic appendectomy. Methods After IRB approval, children who underwent laparoscopic appendectomy for nonperforated acute appendicitis were recruited to the study. For these patients, our standard practice is to provide instructions to administer alternating acetaminophen and ibuprofen over-the-counter (OTC) postoperatively, and no opiate prescriptions are written. Parents of enrolled children received a daily RedCap survey via text message or e-mail on postoperative days (POD) 1 through 5 to prospectively assess pain control and medication usage. Trends were compared across postoperative days. Results One hundred twenty patients were enrolled in the study, and none received opiate prescriptions. Postoperative pain survey response rates were 54% on POD1, 47% on POD2, 35% on POD3, 34% on POD4, and 29% on POD5. Pain level was 4.7 ± 2.3 (out of 10) on POD1, and down-trended significantly each postoperative day to reach 0.7 ± 1.2 by POD5. On POD1, 85% of parents administered OTC medications, which reduced significantly to 14% by POD5. Parent-reported success rates to manage pain by OTC regimen were 85% on POD1, 94% on POD2, 91% on POD3, and 100% on POD4 and POD5. Conclusion Strict non-opioid pain control after appendectomy exhibits high performance based upon prospective parental surveys. This strategy should be implemented as standard of care and tested for application to other surgical conditions. Level of Evidence Level II.
- Subjects :
- Male
Parents
medicine.medical_specialty
Adolescent
Ibuprofen
03 medical and health sciences
0302 clinical medicine
Surveys and Questionnaires
030225 pediatrics
Internal medicine
medicine
Appendectomy
Humans
Pain Management
Postoperative Period
Prospective Studies
Medical prescription
Child
Acetaminophen
Pain, Postoperative
business.industry
General Medicine
Evidence-based medicine
Analgesics, Non-Narcotic
Appendicitis
medicine.disease
Analgesics, Opioid
Regimen
Opioid
Child, Preschool
030220 oncology & carcinogenesis
Pediatrics, Perinatology and Child Health
Female
Laparoscopy
Surgery
Opiate
business
medicine.drug
Subjects
Details
- ISSN :
- 00223468
- Volume :
- 55
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Surgery
- Accession number :
- edsair.doi.dedup.....b53c0d4995252660d5762f8438d23800