Nav: Home

One-third of children having tonsillectomies benefitted from opioid-free surgery and recovery

October 20, 2019

ORLANDO, Fla. - Nearly one-third of children who had surgery to remove their tonsils did not need opioids to get adequate pain relief during and after surgery, according to a study presented at the ANESTHESIOLOGY® 2019 annual meeting.

Tonsillectomy is one of the most common pediatric surgical procedures in the U.S., with more than 530,000 performed each year. Children may need this surgery because they experience abnormal breathing patterns while sleeping, including obstructive sleep apnea - a potentially dangerous condition in which breathing gets partially or completely blocked during sleep.

"These patients are especially at risk for breathing difficulties after tonsillectomy, and these risks can increase from using opioids," said Glenn Mann, M.D., lead author of the study and chief of pediatric anesthesiology at Montefiore Medical Center, Bronx, New York. "Opioid use for surgery-related pain is a major risk factor in adult patients for future opioid misuse. Recent research suggests that this relationship may exist for pediatric patients as well."

Yet opioids - powerful painkillers that are known to depress breathing and cause other harmful side effects - are commonly used to control pain in children during and after tonsillectomy.

In the study, researchers reviewed surgical records for 323 children who had their tonsils removed at Montefiore Medical Center during an 18-month period. They compared postoperative administration of opioid and non-opioid analgesics, rates of nausea and vomiting, post anesthesia care unit (PACU) length of stay, and inpatient admission within 30 days for children who did and did not receive opioids during tonsillectomy surgery. Those who did not receive opioids had acetaminophen and/or ibuprofen to manage pain during surgery. Almost all children in both groups were given dexamethasone and dexmedetomidine, which have pain relief properties.

The authors found:
  • 32% of all patients studied had a completely opioid-free surgical experience
      o More than 40% of patients did not receive opioids during surgery. Of those, a majority (73%) also did not require opioids postoperatively.
  • About one-third of patients in both groups - those who received opioids during surgery vs. those who did not - didn't require any additional pain medication in the PACU prior to discharge (28% vs. 34% respectively)

  • Length of stay in the PACU, a way to measure postoperative pain and other complications, was similar in both groups (143 minutes for children who received opioids during surgery vs. 147 minutes for those who didn't)
"There are a number of studies that look at pain management for tonsillectomy and how to limit opioids. However, few have examined a completely opioid-free technique," said Dr. Mann. "We believe this research is important because it has the potential to offer physician anesthesiologists a safe and effective regimen for tonsillectomy that is opioid-free and potentially reduces risks associated with opioid use."
-end-
THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS

Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 53,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Join the ANESTHESIOLOGY® 2019 social conversation today. Like ASA on Facebook, follow ASALifeline on Twitter and use the hashtag #ANES19.

American Society of Anesthesiologists

Related Opioids Articles:

Opioids for chronic non-cancer pain doubled in quarter century
A review of 24 years of global research has shown opioid prescribing doubled between 1991-2015, with demand most common for chronic conditions such as chronic lower back pain, finds University of Sydney-led research.
Cancer screening among women prescribed opioids
US women who take prescription opioids are no less likely to receive key cancer screenings when compared to women who are not prescribed opioids.
Parents: Turkey makes great leftovers -- opioids do not
Leftover prescription opioids pose big risks to kids, yet most parents keep their own and their child's unused painkillers even after they're no longer medically necessary for pain.
Co-addiction of meth and opioids hinders treatment
A study published in the Journal of Substance Abuse Treatment found that methamphetamine use was associated with more than twice the risk for dropping out of treatment for opioid-use disorder.
Computer game may help to predict reuse of opioids
A computer betting game can help predict the likelihood that someone recovering from opioid addiction will reuse the pain-relieving drugs, a new study shows.
Postpartum women are getting prescribed more opioids than needed
New University of Minnesota Medical School research finds postpartum women are generally getting prescribed more narcotics than they need.
Cannabis found not to be a substitute for opioids
The research team looked at all research on the effects of cannabis use on illicit opioid use during methadone maintenance therapy, which is a common treatment for opioid use disorder, and found six studies involving more than 3,600 participants.
VA investigates impact of opioids, sedatives on veterans
Nearly 20 veterans kill themselves each day in the United States, a statistic that has led the Department of Veterans Affairs to make suicide prevention its highest priority and to recognize the risks from the simultaneous use of opioids and benzodiazepines.
Of all professions, construction workers most likely to use opioids and cocaine
Construction workers are more likely to use drugs than workers in other professions, finds a study by the Center for Drug Use and HIV/HCV Research (CDUHR) at NYU College of Global Public Health.
US-born residents more than 5 times likely to use prescription opioids than new immigrants
The longer immigrants live in the United States, the more likely they are to use prescription opioids -- a fact that contradicts popular views linking wealth and health, and suggests that American culture is uniquely favorable toward prescribing opioids.
More Opioids News and Opioids 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

Listen Again: Meditations on Loneliness
Original broadcast date: April 24, 2020. We're a social species now living in isolation. But loneliness was a problem well before this era of social distancing. This hour, TED speakers explore how we can live and make peace with loneliness. Guests on the show include author and illustrator Jonny Sun, psychologist Susan Pinker, architect Grace Kim, and writer Suleika Jaouad.
Now Playing: Science for the People

#565 The Great Wide Indoors
We're all spending a bit more time indoors this summer than we probably figured. But did you ever stop to think about why the places we live and work as designed the way they are? And how they could be designed better? We're talking with Emily Anthes about her new book "The Great Indoors: The Surprising Science of how Buildings Shape our Behavior, Health and Happiness".
Now Playing: Radiolab

The Third. A TED Talk.
Jad gives a TED talk about his life as a journalist and how Radiolab has evolved over the years. Here's how TED described it:How do you end a story? Host of Radiolab Jad Abumrad tells how his search for an answer led him home to the mountains of Tennessee, where he met an unexpected teacher: Dolly Parton.Jad Nicholas Abumrad is a Lebanese-American radio host, composer and producer. He is the founder of the syndicated public radio program Radiolab, which is broadcast on over 600 radio stations nationwide and is downloaded more than 120 million times a year as a podcast. He also created More Perfect, a podcast that tells the stories behind the Supreme Court's most famous decisions. And most recently, Dolly Parton's America, a nine-episode podcast exploring the life and times of the iconic country music star. Abumrad has received three Peabody Awards and was named a MacArthur Fellow in 2011.