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

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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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Clinical Practice Guideline: Tonsillectomy in Children (Update)

Ron B Mitchell, Sanford M Archer, Stacey L Ishman … (2019)

This update of a 2011 guideline developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Tonsillectomy is one of the most common surgical procedures in the United States, with 289,000 ambulatory procedures performed annually in children <15 years of age based on the most recent published data. This guideline is intended for all clinicians in any setting who interact with children who may be candidates for tonsillectomy.

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Author and article information

Contributors

Zi Y. Jiang:

ORCID: http://orcid.org/0000-0001-8800-0678

zi.yang.jiang@uth.tmc.edu

Journal

Journal ID (nlm-ta): Otolaryngol Head Neck Surg

Journal ID (iso-abbrev): Otolaryngol Head Neck Surg

Journal ID (doi): 10.1002/(ISSN)1097-6817

Journal ID (publisher-id): OHN

Title: Otolaryngology--Head and Neck Surgery

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Print): 0194-5998

ISSN (Electronic): 1097-6817

Publication date (Electronic): 04 November 2024

Publication date (Print): March 2025

Volume: 172

Issue: 3 ( doiID: 10.1002/ohn.v172.3 )

Pages: 1072-1076

Affiliations

[ ¹ ] Department of Otolaryngology–Head and Neck Surgery Houston Methodist Hospital Houston Texas USA

[ ² ] Rutgers Robert Wood Johnson Medical School New Brunswick New Jersey USA

[ ³ ] Department of Otorhinolaryngology–Head and Neck Surgery The University of Texas Health Science Center at Houston Houston Texas USA

Author notes

[*] [* ] Corresponding Author: Zi Y. Jiang, MD, Department of Otorhinolaryngology–Head and Neck Surgery, The University of Texas Health Science Center at Houston, 6400 Fannin St. Suite 2700, Houston, TX 77030, USA.

Email: zi.yang.jiang@ 123456uth.tmc.edu

Author information

Najm S. Khan http://orcid.org/0000-0003-2701-4798

David Z. Allen http://orcid.org/0000-0002-6727-4378

Yin Yiu http://orcid.org/0000-0002-5040-4308

Masayoshi Takashima http://orcid.org/0000-0001-9790-3529

Zi Y. Jiang http://orcid.org/0000-0001-8800-0678

Article

Publisher ID: OHN1048

DOI: 10.1002/ohn.1048

PMC ID: 11844330

PubMed ID: 39497444

SO-VID: 862ea91d-72b3-456e-a6d4-26edd9635c16

License:

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

History

Date revision received : 23 October 2024

Date received : 20 April 2024

Date accepted : 25 October 2024

Page count

Figures: 1, Tables: 1, Pages: 5, Words: 1938

Custom metadata

source-schema-version-number 2.0

cover-date March 2025

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.5.4 mode:remove_FC converted:21.02.2025

ScienceOpen disciplines: Surgery

Keywords: adenoidectomy,clinical practice guideline,narcotic,opioid,pediatric otolaryngology,tonsillectomy

Data availability:

ScienceOpen disciplines: Surgery

Keywords: adenoidectomy, clinical practice guideline, narcotic, opioid, pediatric otolaryngology, tonsillectomy

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

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Most cited references 15

The answer is 17 years, what is the question: understanding time lags in translational research

Practice-based research--"Blue Highways" on the NIH roadmap.

Clinical Practice Guideline: Tonsillectomy in Children (Update)

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