Nav: Home

Six in 10 children receive opioids after tonsillectomy

August 08, 2019

ANN ARBOR, Mich. - Sixty percent of privately insured children undergoing tonsil removal received opioids -with average prescriptions lasting about six to 10 days - a new study finds.

And while the more powerful painkillers are often prescribed because they have been believed to reduce the risk of complications such as poorly controlled pain, researchers did not find evidence indicating that opioids protected children against those risks.

The Michigan Medicine study appears in the journal JAMA Otolaryngology-Head & Neck Surgery.

"Our findings suggest that it may be possible to reduce opioid exposure among children who undergo this common surgery without increasing the risk of complications," says lead author Kao-Ping Chua, M.D., Ph.D., a researcher and pediatrician at University of Michigan C.S. Mott Children's Hospital and the U-M Institute for Healthcare Policy and Innovation.

Researchers analyzed national data between 2016 and 2017 from a private insurance database. Among 15,793 children (ages 1 to 18) who underwent a tonsillectomy, six in 10 had one or more filled opioid prescription.

Tonsillectomy is one of the most common surgical procedures performed in children. American Academy of Otolaryngology guidelines strongly recommend non-opioids, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, for these procedures.

Chua says there are several possible explanations for why so many children still received opioid prescriptions despite these guidelines. Among the biggest potential reasons is that the potent painkillers have been believed to provide superior pain relief and reduce risk of return visits for uncontrolled pain leading to dehydration.

In the University of Michigan study, having a filled opioid prescription wasn't associated with a difference in risk of return visits for pain or dehydration. But it was linked to an increased risk of constipation and in at least one case, an opioid overdose, the study found.

Chua believes surgeons may also prescribe opioids after tonsillectomy because they fear that NSAID use increases bleeding risk. But clinical trials have not demonstrated a significant increase in bleeding risk with NSAID use. In the new Michigan study, having a filled opioid prescription was not associated with increased risk of bleeding, suggesting that prescribing opioids may not protect against this complication.

Among children with perioperative fills, the median prescription duration was eight days, an amount that could represent 48 doses of opioids. This is far greater than what the average patient needs, researchers say. A previous study at Mott found that children undergoing tonsillectomy in 2013 were prescribed an average of 52 opioid doses but had an average of 44 leftover opioid doses.

Over-prescribing opioids to children isn't just a health risk to children, Chua says, but also to family and friends who may have access to the leftover opioids that may not be properly disposed.

"To minimize the risks of opioids to children and their families, clinicians should rely on non-opioids when possible. When opioids are used, clinicians should aim to prescribe only the amount that patients need," Chua says.

"However, our study suggests that many children receive opioid prescriptions after tonsillectomy and that the amount of opioids in these prescriptions may be excessive. We need to conduct research to identify interventions that safely and effectively reduce opioid exposure for these children."
-end-


Michigan Medicine - University of Michigan

Related Science Articles:

75 science societies urge the education department to base Title IX sexual harassment regulations on evidence and science
The American Educational Research Association (AERA) and the American Association for the Advancement of Science (AAAS) today led 75 scientific societies in submitting comments on the US Department of Education's proposed changes to Title IX regulations.
Science/Science Careers' survey ranks top biotech, biopharma, and pharma employers
The Science and Science Careers' 2018 annual Top Employers Survey polled employees in the biotechnology, biopharmaceutical, pharmaceutical, and related industries to determine the 20 best employers in these industries as well as their driving characteristics.
Science in the palm of your hand: How citizen science transforms passive learners
Citizen science projects can engage even children who previously were not interested in science.
Applied science may yield more translational research publications than basic science
While translational research can happen at any stage of the research process, a recent investigation of behavioral and social science research awards granted by the NIH between 2008 and 2014 revealed that applied science yielded a higher volume of translational research publications than basic science, according to a study published May 9, 2018 in the open-access journal PLOS ONE by Xueying Han from the Science and Technology Policy Institute, USA, and colleagues.
Prominent academics, including Salk's Thomas Albright, call for more science in forensic science
Six scientists who recently served on the National Commission on Forensic Science are calling on the scientific community at large to advocate for increased research and financial support of forensic science as well as the introduction of empirical testing requirements to ensure the validity of outcomes.
World Science Forum 2017 Jordan issues Science for Peace Declaration
On behalf of the coordinating organizations responsible for delivering the World Science Forum Jordan, the concluding Science for Peace Declaration issued at the Dead Sea represents a global call for action to science and society to build a future that promises greater equality, security and opportunity for all, and in which science plays an increasingly prominent role as an enabler of fair and sustainable development.
PETA science group promotes animal-free science at society of toxicology conference
The PETA International Science Consortium Ltd. is presenting two posters on animal-free methods for testing inhalation toxicity at the 56th annual Society of Toxicology (SOT) meeting March 12 to 16, 2017, in Baltimore, Maryland.
Citizen Science in the Digital Age: Rhetoric, Science and Public Engagement
James Wynn's timely investigation highlights scientific studies grounded in publicly gathered data and probes the rhetoric these studies employ.
Science/Science Careers' survey ranks top biotech, pharma, and biopharma employers
The Science and Science Careers' 2016 annual Top Employers Survey polled employees in the biotechnology, biopharmaceutical, pharmaceutical, and related industries to determine the 20 best employers in these industries as well as their driving characteristics.
Three natural science professors win TJ Park Science Fellowship
Professor Jung-Min Kee (Department of Chemistry, UNIST), Professor Kyudong Choi (Department of Mathematical Sciences, UNIST), and Professor Kwanpyo Kim (Department of Physics, UNIST) are the recipients of the Cheong-Am (TJ Park) Science Fellowship of the year 2016.
More Science News and Science Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Teaching For Better Humans 2.0
More than test scores or good grades–what do kids need for the future? This hour, TED speakers explore how to help children grow into better humans, both during and after this time of crisis. Guests include educators Richard Culatta and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#556 The Power of Friendship
It's 2020 and times are tough. Maybe some of us are learning about social distancing the hard way. Maybe we just are all a little anxious. No matter what, we could probably use a friend. But what is a friend, exactly? And why do we need them so much? This week host Bethany Brookshire speaks with Lydia Denworth, author of the new book "Friendship: The Evolution, Biology, and Extraordinary Power of Life's Fundamental Bond". This episode is hosted by Bethany Brookshire, science writer from Science News.
Now Playing: Radiolab

Space
One of the most consistent questions we get at the show is from parents who want to know which episodes are kid-friendly and which aren't. So today, we're releasing a separate feed, Radiolab for Kids. To kick it off, we're rerunning an all-time favorite episode: Space. In the 60's, space exploration was an American obsession. This hour, we chart the path from romance to increasing cynicism. We begin with Ann Druyan, widow of Carl Sagan, with a story about the Voyager expedition, true love, and a golden record that travels through space. And astrophysicist Neil de Grasse Tyson explains the Coepernican Principle, and just how insignificant we are. Support Radiolab today at Radiolab.org/donate.