The following article features coverage from the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNSF) Annual Meeting. Click here to read more of MPR‘s conference coverage.

The use of narcotic medications in pediatric patients following endoscopic sinus surgery was associated with higher rates of postoperative complications, according to findings presented at the AAO-HNSF 2021 Annual Meeting.

To better understand postoperative pain management prescribing patterns, the study authors used the IBM MarketScan Commercial Claims and Encounters Database to identify patients younger than 18 years of age who underwent endoscopic sinus surgery between 2016 and 2018. 


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“Univariate and multivariate analyses were performed to analyze the use of narcotics based on demographics and surgical procedure and to investigate the relationship of narcotics to 30-day postoperative morbidity,” the authors explained.

Among the 2981 patients included in the analysis, 59.1% were 13 years of age or older. Ten percent of patients received narcotic medications following surgery, and those over the age of 13 were more likely to receive these medications for pain (odds ratio [OR], 2.363; 95% CI, 1.59-3.52).

Multivariate analyses showed that the use of narcotic medications was significantly associated with greater 30-day postoperative complications (OR, 1.87; 95% CI 1.38-2.54), as well as emergency department visits (OR, 2.68; 95% CI, 1.81-3.98) and hospital readmissions (OR, 2.45; 95% CI, 1.59-3.78).

Location also played a factor, with certain parts of the country having higher rates of narcotic use than others.

“Narcotic medication was more likely to be prescribed in older children indicating patient age is a factor in surgeon comfort level with narcotic prescriptions and decision to prescribe,” the authors concluded.

Reference

Thomas S, Guodong L, Wilson MN. Narcotic use following pediatric sinus surgery: a national analysis. AAO-HNSF 2021 Annual Meeting; October 3-6, 2021; Los Angeles, CA.