No Evidence for Benefits of Opioids After Pediatric Tonsillectomy

For children undergoing tonsillectomy, having perioperative opioid fills is not associated with return visits for pain or dehydration, according to a study published online in JAMA Otolaryngology-Head & Neck Surgery.

Kao-Ping Chua, M.D., Ph.D., from the University of Michigan in Ann Arbor, and colleagues conducted a cohort analysis involving 22,567 opioid-naive children aged 1 to 18 years with a claims code for tonsillectomy with or without adenoidectomy; the final sample included 15,793 children.

The researchers found that 59.6 percent of children had one or more perioperative fills and the median duration was eight days. Across U.S. census divisions, there was variation noted in the probability of having one or more perioperative fills and in the duration of prescription. Compared with children not using opioids, having one or more perioperative fills was not associated with return visits for pain or dehydration (adjusted odds ratio, 1.13; 95 percent confidence interval, 0.95 to 1.34) or secondary hemorrhage (adjusted odds ratio, 0.90; 95 percent confidence interval, 0.73 to 1.10); there was a correlation seen with increased risk of return visits for constipation (adjusted odds ratio, 2.02; 95 percent confidence interval, 1.24 to 3.28).

"To minimize the risks of opioids to children and their families, clinicians should rely on nonopioids when possible," Chua said in a statement. "When opioids are used, clinicians should aim to prescribe only the amount that patients need."

One author disclosed financial ties to the pharmaceutical industry and reported having a patent for peripheral perineural dexmedetomidine.

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