Variation in opioid utilization among neonates with gastroschisis
Copyright © 2021. Published by Elsevier Inc..
PURPOSE: Repetitive painful stimuli and early exposure to opioids places neonates at risk for neurocognitive delays. We aimed to understand opioid utilization for neonates with gastroschisis.
METHODS: We performed a retrospective review of infants with gastroschisis at a tertiary children's hospital (2017-2019). Multivariate linear regression was performed to analyze variations in opioid use.
RESULTS: Among 30 patients with gastroschisis, 33% were managed by primary suture-less closure, 7% by primary sutured closure, 40% by spring silo, and 20% by handsewn silo. The proportion of pain medication used was: morphine (89%), acetaminophen (8%), and fentanyl (3%). Opioids were used for a median of 6.5 days (range 0-20) per patient. Median total opioid administered across all patients was 2.2 morphine milligram equivalents (MME)/kg (IQR 0.7-3.3). Following definitive closure, median opioid use was 0.2 MME/kg (IQR 0.1-0.8). With multivariate regression, 45% of the variation in MME use was associated with the type of surgery after adjusting for weight, gestational age, and gender, p = 0.02. After definitive fascial closure, there was no significant variations in opioid use.
CONCLUSION: There is a significant variation in the utilization of opioid, primarily prior to fascial closure. Understanding pain needs and standardization may improve opioid stewardship in infants with gastroschisis. 197/200 LEVEL OF EVIDENCE: Level III.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:56 |
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| Enthalten in: |
Journal of pediatric surgery - 56(2021), 7 vom: 01. Juli, Seite 1113-1116 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Li, Linda T [VerfasserIn] |
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| Links: |
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| Themen: |
76I7G6D29C |
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| Anmerkungen: |
Date Completed 25.06.2021 Date Revised 25.06.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jpedsurg.2021.03.030 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM323919448 |
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| 500 | |a Date Revised 25.06.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021. Published by Elsevier Inc. | ||
| 520 | |a PURPOSE: Repetitive painful stimuli and early exposure to opioids places neonates at risk for neurocognitive delays. We aimed to understand opioid utilization for neonates with gastroschisis | ||
| 520 | |a METHODS: We performed a retrospective review of infants with gastroschisis at a tertiary children's hospital (2017-2019). Multivariate linear regression was performed to analyze variations in opioid use | ||
| 520 | |a RESULTS: Among 30 patients with gastroschisis, 33% were managed by primary suture-less closure, 7% by primary sutured closure, 40% by spring silo, and 20% by handsewn silo. The proportion of pain medication used was: morphine (89%), acetaminophen (8%), and fentanyl (3%). Opioids were used for a median of 6.5 days (range 0-20) per patient. Median total opioid administered across all patients was 2.2 morphine milligram equivalents (MME)/kg (IQR 0.7-3.3). Following definitive closure, median opioid use was 0.2 MME/kg (IQR 0.1-0.8). With multivariate regression, 45% of the variation in MME use was associated with the type of surgery after adjusting for weight, gestational age, and gender, p = 0.02. After definitive fascial closure, there was no significant variations in opioid use | ||
| 520 | |a CONCLUSION: There is a significant variation in the utilization of opioid, primarily prior to fascial closure. Understanding pain needs and standardization may improve opioid stewardship in infants with gastroschisis. 197/200 LEVEL OF EVIDENCE: Level III | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Gastroschisis | |
| 650 | 4 | |a Narcotics | |
| 650 | 4 | |a Neonatology | |
| 650 | 4 | |a Opioids | |
| 650 | 4 | |a Pain management | |
| 650 | 4 | |a Variability | |
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| 650 | 7 | |a Morphine |2 NLM | |
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| 700 | 1 | |a Reynolds, Eric W |e verfasserin |4 aut | |
| 700 | 1 | |a Arshad, Seyed A |e verfasserin |4 aut | |
| 700 | 1 | |a Hatton, Gabrielle E |e verfasserin |4 aut | |
| 700 | 1 | |a Ferguson, Dalya M |e verfasserin |4 aut | |
| 700 | 1 | |a Austin, Mary T |e verfasserin |4 aut | |
| 700 | 1 | |a Lally, Kevin P |e verfasserin |4 aut | |
| 700 | 1 | |a Tsao, Kuojen |e verfasserin |4 aut | |
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