About My Health Careers Internship MedBlogs Contact us
Medindia LOGIN REGISTER
Advertisement

Overprescription of Opioids for Elbow Fractures in Children: CHOP Surgeons

by Ramya Rachamanti on January 17, 2019 at 11:44 AM
Font : A-A+

Overprescription of Opioids for Elbow Fractures in Children: CHOP Surgeons

Opioids prescribed to children for pain relief after a typical pediatric orthopaedic procedure may be overprescribed, according to a new study by researchers at Children's Hospital of Philadelphia (CHOP).

The patients used less than 25 percent of the drugs, suggesting a potential risk of opioid diversion. The findings were published in the Journal of Bone and Joint Surgery.

Advertisement


Opioid diversion and non-medical use of opioids are tremendous challenges as the medical community strives to achieve improved opioid stewardship. This is especially true in orthopaedics. Across the country, more than half of all opioid prescriptions were given to patients discharged by orthopaedic surgeons.

Additionally, about 40 percent of adolescents who took opioids for non-medical reasons had access to them from leftover prescriptions. Adolescents are also more likely to abuse substances as adults if they have used opioids for both medical and non-medical reasons. While younger children are less likely to abuse opioids, accidental ingestion is on the rise and can result in significant injury or death.
Advertisement

"When we're prescribing analgesic opioids for young patients, we not only want to avoid over treating this group of patients, but we also want to make sure we're not undertreating pain as they recover from surgery," said Apurva Shah, MD, MBA, an orthopaedic surgeon at CHOP, co-director of the Brachial Plexus Injury Program and lead author of this study.

To determine the optimal dose of opioids that should be prescribed, Shah and his colleagues launched a prospective study of patients who underwent closed reduction and percutaneous pinning (CRPP) of supracondylar humerus (SCH) fractures -- the most common elbow fracture in children.

The patients' families received text messages twice a day asking the patient to rate their level of pain using the Faces Pain Scale, a self-reporting pain measure developed specifically for children.

A total of 81 patients with a mean age of 6.1 years old were enrolled in the study. As expected, pain ratings were highest on arrival to the emergency department and the first day after the operation, with mean pain ratings and opioid doses decreasing by the third day.

Patients reported using only 24.1 percent of prescribed opioids on average. Additionally, 18 patients reported not taking any opioid medications after they were discharged, while 18 patients also reported that they had taken over-the-counter (OTC) medications like ibuprofen or acetaminophen.

Only 11 patients were taking any analgesic medication 10 days after their operation. By day 14, six patients were taking OTC analgesics, and by day 21, only four patients were still taking OTC analgesics.

"This study suggests that orthopaedic surgeons really need to think about our current prescribing practices and how we can help decrease the potential for overprescription and opioid diversion," Shah said. "Based on this study, which we believe can be applied to other common types of orthopaedic injuries, a prescription for a much shorter period of time seems to be appropriate."

The authors also suggest a prospective study to investigate whether non-narcotic analgesic medications are as effective in managing pain for patients who experience these common childhood injuries.



Source: Eurekalert
Advertisement

Advertisement
News A-Z
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
News Category
What's New on Medindia
Convulsions / Seizures / Fits - Symptom Evaluation
World Heart Day 2021 -
Are Black Foods the New Superfood?
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
Fracture of Knee Cap Cannabis Drug Abuse Osteochondritis Dissecans Stress Fracture Compound Fractures Elbow Dislocation Elbow pain - Symptom Evaluation Painkiller Addiction Prescription Drug Abuse 

Recommended Reading
Prescription Drug Abuse
Prescription drug abuse is consuming prescription medications in a way different from that as ......
Cannabis
Cannabis has a long history of medicinal, recreational, and industrial use and comes from a bushy pl...
Compound Fractures
Compound Fracture is an injury that occurs when a fracture directly communicates with the external e...
Drug Abuse
The use of Drugs for reasons other than its prescribed recommendation, is known as Drug abuse or sub...
Elbow Dislocation
The elbow is the second most common site where dislocations occur. Elbow dislocation is an emergency...
Fracture of Knee Cap
Patella fracture is a kneecap injury that needs surgical correction. Undisplaced fracture can be hea...
Osteochondritis Dissecans
Osteochondritis dissecans is a relatively rare condition. It is an important cause of joint pain in ...
Painkiller Addiction
Painkiller addiction is the use of prescription painkillers in a way not meant by the prescribing do...
Stress Fracture
Stress fractures are small fractures which often occur in the weight bearing bones of the lower leg ...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2021

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use