No pain is gain: A prospective evaluation of strict non-opioid pain control after pediatric appendectomy

Gee, Kristin M.; Jones, Ruth Ellen; Nevarez, Nicole; McClain, Lauren E.; Wools, Gentry; Beres, Alana L.

doi:10.1016/j.jpedsurg.2020.02.051

Cited by 16 publications

(11 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interrupted time series analysis showed that the PDMP mandate was associated with a significant decrease in the proportion of children receiving opioid prescriptions for a supply of greater than 5 days. It is important to note that we did not see an increase in clinical encounters related to postoperative pain, and recent literature supports that patient and family satisfaction is not compromised by this shift in practice [21]. The ongoing reduction in opioid prescriptions is significant but does not appear to be due exclusively to the PDMP mandate.…”

Section: Discussionmentioning

confidence: 54%

“…Several other groups have reported success with reducing opioid prescriptions via interventions including standardized opioid prescription protocols [12], educational interventions aimed at providers [13,14], and reducing the default number of pills pre-specified in the EMR [16]. A no-opioid pathway following laparoscopic appendectomy has been employed with success at some institutions [21]. The significant decrease in opioid prescriptions seen in this study is likely multifactorial.…”

Section: Discussionmentioning

confidence: 78%

See 1 more Smart Citation

Impact of prescription drug monitoring program mandate on postoperative opioid prescriptions in children

et al. 2021

View full text Add to dashboard Cite

Purpose Prescription drug monitoring programs (PDMPs) have been established to combat the opioid epidemic, but there is no data on their efficacy in children. We hypothesized that a statewide PDMP mandate would be associated with fewer opioid prescriptions in pediatric surgical patients. Methods Patients < 18 undergoing inguinal hernia repair, orchiopexy, orchiectomy, appendectomy, or cholecystectomy at a tertiary children’s hospital were included. The primary outcome, discharge opioid prescription, was compared for 10 months pre-PDMP (n = 158) to 10 months post-PDMP (n = 228). Interrupted time series analysis was performed to determine the effect of the PDMP on opioid prescribing. Results Over the 20-month study period, there was an overall decrease in the rate of opioid prescriptions per month (− 3.6% change, p < 0.001). On interrupted time series analysis, PDMP implementation was not associated with a significant decrease in the monthly rate of opioid prescriptions (1.27% change post-PDMP, p = 0.4). However, PDMP implementation was associated with a reduction in opioid prescriptions of greater than 5 days’ supply (− 2.7% per month, p = 0.03). Conclusion Opioid prescriptions declined in pediatric surgical patients over the study time period. State-wide PDMP implementation was associated with a reduction in postoperative opioid prescriptions of more than 5 days’ duration.

show abstract

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 78%

Impact of prescription drug monitoring program mandate on postoperative opioid prescriptions in children

et al. 2021

View full text Add to dashboard Cite

show abstract

“…This is known as the rst study on the effect of NSAID on the performance and analgestic in MPAT. Etocoxib are some of the most commonly used drugs in the world, 12% of adults report taking NSAIDs regularly [10]. This ratio is as high as 75% among young athletes [11].…”

Section: Discussionmentioning

confidence: 99%

The efficacy of NSAID in performance improving and pain management in military physical aptitude test. An observational study in the military medical personnel

Gan

Sun

et al. 2021

Preprint

View full text Add to dashboard Cite

Background The Chinese military is deepening the strenthening reform and enhancing physical training standards. The sudden increasing in training requirements and outline has increased the pressure of the logistics units, such as medical personnel. Using over-the-counter (OTC) analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs) in the military physical aptitude test (MPAT), has been described as helpful for reducing of post-exercise myalgia (PEM) and improving performance. To verify this hypothesis, we designed and carried out this study. The objective was to explore the effect of NSAID in the performance improvement and relieving of PEM in MPAT. Methods The research subject were military medical personnels who participated in the 2020 winter MPAT in Xi'jing Hospital and Air Force Medical Center both affiliated to Air Force Medical University. The information was collected in the form of measure yourself medical outcome profile (MYMOP2) questionnaires. PEM was assessed using the Visual Analogue Scale (VAS). Test scores including 3000m running and sit-ups were documented detailed. VAS assessment including muscles in lower extremities (LEs) as well as Abdominals (ABs). One of the most commonly used NSAID in clinical practice, etocoxib, was used as an intervention agent in this study. Participants were divided into group A (etoricoxib group) and group B (control group). Given that training intensity and training habits as a impact on outcomes, hence, according to whether they persisted in physical exercise for more than three months, they were subclassified as two subsets: continuous exercise group (A1 and B1), no exercise group (A2 and B2). General information including gender, height, weight and BMI were recorded. MPAT results and PEM were compared and analysised between and within groups. Results A sample of 97 participants were recruited. 41 people were classified as group A, while other 56 people in group B. They were further subdivided into A1 (17 cases) and B1 (27 cases) who had been exercising consistently; A2 (24 cases) and B2 (32 cases) groups that were not. The results showed that MPAT scores in the etoricoxib group are indeed better than those in the no-drug group. Similarly, the VAS score in group A was lower than group B, the difference was statistically significant (P < 0.05). The overall results revealed potential effective for pain relief and performance, which meet the hypothesis. The comparison between subgroups showed that NSAID could alleviate PEM after MPAT regardless of whether exercise was insisted or not. Meanwhile, NSAID improved performance in the muscle explosiveness items (sit-ups), which is prone to cause PEM. However, for endurance items (3000m running), as a matter of fact, continuous physical training maybe demonstrated more effective. Conclusion Taking NSAID while participating in MPAT, overall, did improve test scores and alleviate PEM, especially in the explosive force testing projects. Nevertheless, physical training may be more effective in enhancing endurance. To sum up, whether this practice will bring additional harm to the body and worthy of promoting, still needs further research.

show abstract

“…4 In this study, pediatric surgeons' beliefs were consistent with literature demonstrating opioid-free postoperative pain management is effective. 2,5 However, surgical residents and PACU nurses believed that children would require opioids for up to 3 days. This variability was greatest for teenagers, who are at high risk for opioid abuse.…”

Section: Variations In Perceptions Of Postoperative Opioid Need For P...mentioning

confidence: 99%

“…The commonly used threshold of 50 × 10 3 /μL (to convert platelet count to ×10 9 /L, multiply by 1) is based on expert opinion. 1,2 This study compared bleeding complications in pediatric patients with a platelet count of 50 × 10 3 /μL or above vs below 50 × 10 3 /μL.…”

Section: Accepted Formentioning

confidence: 99%

Variations in Perceptions of Postoperative Opioid Need for Pediatric Surgical Patients

et al. 2021

View full text Add to dashboard Cite

No pain is gain: A prospective evaluation of strict non-opioid pain control after pediatric appendectomy

Cited by 16 publications

References 20 publications

Impact of prescription drug monitoring program mandate on postoperative opioid prescriptions in children

Impact of prescription drug monitoring program mandate on postoperative opioid prescriptions in children

The efficacy of NSAID in performance improving and pain management in military physical aptitude test. An observational study in the military medical personnel

Variations in Perceptions of Postoperative Opioid Need for Pediatric Surgical Patients

Contact Info

Product

Resources

About