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Perioperative factors associated with persistent opioid use after extensive abdominal surgery in children and adolescents: A retrospective cohort study
Author(s) -
OwusuAgyemang Pascal,
Cata Juan P.,
Meter Antoinette Van,
Kapoor Ravish,
Zavala Acsa M.,
Williams Uduak U.,
Tsai January,
Rebello Elizabeth,
Feng Lei,
HayesJordan Andrea
Publication year - 2018
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.13386
Subject(s) - medicine , retrospective cohort study , perioperative , opioid , odds ratio , confidence interval , logistic regression , anesthesia , surgery , receptor
Summary Background In adults, preoperative opioid use and higher perioperative opioid consumption have been associated with higher odds of persistent opioid use after surgery. There are limited data on the prevalence and factors associated with persistent opioid use after major oncologic surgery in children. Aims In this study, we sought to determine the prevalence and factors associated with the development of persistent opioid use in a group of children and adolescents who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Methods A retrospective study of patients ≤19 years of age was performed. Univariable logistic regression was used to assess factors associated with a postdischarge persistent opioid use of up to 6 months. Results Eighty‐six children were identified. The median age was 12 years, and 43% were female. The proportion of patients with persistent opioid use over the immediate 3, 6, 12 and 24 postdischarge months was 54/77 (70%), 18/51 (35%), 13/45 (29%), and 3/24 (13%), respectively. The daily average in‐patient pain scores were higher in the group of children who subsequently developed persistent opioid use of up to 6 months (estimated difference 0.5, 95% confidence interval [ CI ]: 0.3, 0.8, P < .01). Furthermore, higher postoperative opioid consumption was associated with greater odds of a subsequent persistent opioid use of up to 6 months (odds ratio 1.03, 95% CI : 1.00, 1.07, P = .05). Conclusion In this retrospective study of children and adolescents who had undergone a major oncologic surgery, higher in‐patient pain scores and higher postoperative opioid consumption were associated with a persistent opioid use of up to 6 months.