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Opioid prescribing practices in a pediatric burn tertiary care facility: Is it time to change?
- Source :
-
Burns : journal of the International Society for Burn Injuries [Burns] 2020 Feb; Vol. 46 (1), pp. 219-224. Date of Electronic Publication: 2019 Dec 18. - Publication Year :
- 2020
-
Abstract
- Opioids are the mainstay therapy in burned adults. Little data in the pediatric burn population exists that elucidates opioid prescribing practices. The primary purpose of this report is to quantify opioid and non-opioid analgesic use in pediatric burn patients admitted to a tertiary referral burn center. A retrospective audit of hospital charts and discharge records for patients <18 years old from March 2016 to March 2017 was performed. Opioid amounts were converted to either oral morphine miligram equivalents (MME) or oral MME per day and subsequently adjusted for age in kilograms (kg). Of the 226 patients, 223 (98.7%) were administered an opioid during admission. The median total opioid amount administered during admission was 0.4 (IQR: 0.3-0.6) mg oral MME per kilogram per day. Anecdotally, doses above 1 mg/kg/day are considered high risk for opioid tolerance. The median total opioid amount prescribed upon discharge was high at 3.9 (IQR: 2.3, 5.6) mg of oral MME per kilogram. Hydrocodone (96.0%) was the most common opioid administered, followed by morphine (88.1%). The most commonly prescribed discharge opioid was hydrocodone (95.4%). Non-opoioid analgesia during admission was used in 112 patients (49.6%). This study provides novel insight into the opioid practices at a tertiary burn center for pediatric patients, with our analysis showcasing high usage of opioids during admission and discharge for burn analgesia. It emphasizes the need to expand beyond opioids for burn analgesia and the importance of promoting non-opioid, multimodal analgesia in the pediatric burn population.<br /> (Copyright © 2019 Elsevier Ltd and ISBI. All rights reserved.)
- Subjects :
- Acetaminophen therapeutic use
Administration, Intravenous
Administration, Oral
Adolescent
Ambulatory Care
Burn Units
Child
Child, Preschool
Codeine therapeutic use
Drug Combinations
Female
Fentanyl therapeutic use
Hospitalization
Humans
Hydrocodone therapeutic use
Hydromorphone therapeutic use
Infant
Length of Stay
Male
Morphine therapeutic use
Patient Discharge
Retrospective Studies
Tertiary Care Centers
Tramadol therapeutic use
Analgesics, Non-Narcotic therapeutic use
Analgesics, Opioid therapeutic use
Anesthesia, Conduction statistics & numerical data
Burns therapy
Pain Management methods
Practice Patterns, Physicians' statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1409
- Volume :
- 46
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Burns : journal of the International Society for Burn Injuries
- Publication Type :
- Academic Journal
- Accession number :
- 31862279
- Full Text :
- https://doi.org/10.1016/j.burns.2019.07.016