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Michigan OPEN

Ortho recs mockup – OLD

MOCKUP

PEDIATRIC OPIOID PRESCRIBING RECOMMENDATIONS

Orthopedics
Doses^ of Opioid
0

DATA ANALYSIS:

  • Included Procedures: Tendon Repair-Achilles, Heel Cord Lengthening, Tendon Transfer/Lengthening, Open Reduction Hip, Flap closure, Forehead flap to nasal defect, Cyst, Skin tag, Lipoma or Keloid Excision, I and D, Mass excision, Foreign Body Removal
  • Patient Reported Outcomes data collected via C.S. Mott Children’s Hospital, Michigan Medicine
  • March 2021 – August 2022
  • 37 Opioid Naïve Patients
  • Pain Score (median): 3
  • Satisfaction with Pain Management (median): 5

 

SUPPORTING LITERATURE:

McKenna et al., 2021 (Level 3 evidence)

  • DOI: 10.1097/GOX.0000000000003466.
  • Pediatric patients aged 6 months to 18 years who underwent outpatient excision of a soft tissue lesion or cyst by Plastic Surgery from January 2015-March 2020. Intervention implemented from February September 2018
  • Intervention = discussion of variable prescribing patterns in a faculty meeting and order set with acetaminophen/ibuprofen at weight-based dosing and recommendation against opioid
  • Some differentiation between <3 cm lesions and >3 cm lesions
  • Chart review for patient satisfaction
  • After intervention, percentage of patients receiving an opioid prescription dropped from 18% to 6%
  • After intervention, patient reported satisfaction with pain control improved
  • Pain control satisfaction was independent of closure size or receipt of postoperative opioid prescription
  • Conclusion: raising provider awareness, educating patients on pain management options, and prioritizing non-opioid analgesics reduced opioid prescription
0

DATA ANALYSIS:

  • Included Procedures: Percutaneous Pinning Wrist, Percutaneous Pinning Elbow, Percutaneous Pinning Humerus
  • Patient Reported Outcomes data collected via C.S. Mott Children’s Hospital, Michigan Medicine
  • March 2021 – August 2022
  • 64 Opioid Naïve Patients
  • Pain Score (median): 2
  • Satisfaction with Pain Management (median): 5

 

0-5

Data Analysis

  • Included Procedures: Bone Cyst Curettage/Excision, Bone Biopsy, Ankle External Fixator Removal, Hardware Removal Tibia, Hardware Removal Femur, Hardware Removal Fibula, Osteotomy With Rotation Femur, Osteotomy With Rotation Tibia, Osteotomy with Shortening Femur, Osteotomy with Shortening Tibia
  • Patient Reported Outcomes data collected via C.S. Mott Children’s Hospital, Michigan Medicine 
  • March 2021 – August 2022
  • 46 Opioid Naïve Patients
  • Pain Score (median): 3
  • Satisfaction with Pain Management (median): 5
0-5

DATA ANALYSIS:

  • Included Procedures: Complex Hand Procedure, Simple Hand Procedure, Polydactyly Thumb Reconstruction, Trigger Finger Release
  • Patient Reported Outcomes data collected via C.S. Mott Children’s Hospital, Michigan Medicine
  • March 2021 – August 2022
  • 34 Opioid Naïve Patients
  • Pain Score (median): 3
  • Satisfaction with Pain Management (median): 5

 

0-5

DATA ANALYSIS:

  • Included Procedures: Orif Elbow, Orif Humerus, Orif Radius, Orif Ulna
  • Patient Reported Outcomes data collected via C.S. Mott Children’s Hospital, Michigan Medicine
  • March 2021 – August 2022
  • 33 Opioid Naïve Patients
  • Pain Score (median): 2
  • Satisfaction with Pain Management (median): 5

 

0-10

DATA ANALYSIS:

  • Included Procedures: Orif Tibia, Orif Ankle, Orif Femur, Orif Hip, Orif Acetabulum Or Pelvis, Varus or Dega Femoral Osteotomy, Salter Osteotomy, Periacetabular Osteotomy
  • Patient Reported Outcomes data collected via C.S. Mott Children’s Hospital, Michigan Medicine
  • March 2021 – August 2022
  • 57 Opioid Naïve Patients
  • Pain Score (median): 3
  • Satisfaction with Pain Management (median): 5
0-15

DATA ANALYSIS:

  • Included Procedures: Ankle Arthroscopy, Knee Arthroscopy, Hamstring ACL Reconstruction, Open Knee Repair/ Reconstruction
  • Patient Reported Outcomes data collected via C.S. Mott Children’s Hospital, Michigan Medicine
  • March 2021 – August 2022
  • 132 Opioid Naïve Patients
  • Pain Score (median): 3
  • Satisfaction with Pain Management (median): 5