Opioid Prescription Patterns for Children Following Laparoscopic Appendectomy

OBJECTIVE:To describe variability in and consequences of opioid prescriptions following pediatric laparoscopic appendectomy. SUMMARY BACKGROUND DATA:Postoperative opioid prescribing patterns may contribute to persistent opioid use in both adults and children. METHODS:We included children 14 d, RR = 6.27, 95% CI = 1.23–19.68], compared with no opioid prescription. There was similar or increased risk of ED visit for pain (n = 319, 5%) with opioid prescription [1–3 d, RR = 1.00, 95% confidence interval (CI) = 0.74–1.32; 4–6 d, RR = 1.31, 95% CI = 0.99–1.73; 7–14 d, RR = 1.52, 95% CI = 1.00–2.18], compared with no opioid prescription. Likewise, need for refill (n = 157, 3%) was not associated with initial days of opioid prescribed (reference 1–3 d; 4–6 d, RR = 0.96, 95% CI = 0.68–1.35; 7–14 d, RR = 0.91, 95% CI = 0.49–1.46; and >14 d, RR = 1.22, 95% CI = 0.59–2.07). CONCLUSIONS:There was substantial variation in opioid prescribing patterns. Opioid prescription duration increased risk of ED visits for constipation, but not for pain or refill.