(A940) Opioid Utilization in Post-Tonsillectomy Pediatric Patients

Introduction: Post-operative pain in tonsillectomy can be variable and complex for patients and their caregivers. Here, we evaluate post-operative pain, oxycodone usage, and plans for disposal in pediatric tonsillectomy patients.

Methods: We performed a prospective study of patients undergoing tonsillectomy at our tertiary academic center from 2019 to 2022. Patients with prolonged hospitalization, another surgery within 2 weeks, organ transplant, chronic pain, congenital disorders, or diagnoses altering pain were excluded. Patients were prescribed ibuprofen and acetaminophen with oxycodone for breakthrough pain. Demographics, patient characteristics, and plans for opioid disposal were recorded. Data on analgesic use, pain scores, and opioid disposal methods were collected via post-op telephone survey. Patients were deemed lost to follow-up after 4 unsuccessful attempts to contact them.

Results: We enrolled 46 patients and lost 8 to follow-up. Mean age was 14.2 (range 8 – 18). Mean oxycodone usage was 8.1 doses. Opioid-naïve patients (6.9 ± 6.5 doses) did not have greater oxycodone use compared to those not naïve (10.3 ± 9.1, p=0.19). Hispanic-identifying patients reported less median oxycodone usage (2.5) compared to non-Hispanic patients (16, p=0.001). 56.5% of caregivers did not have a disposal plan for leftover oxycodone at initial survey. Multivariable linear regression analysis found a negative correlation between patients identifying as male (p=0.012) or Hispanic. (p=0.049) with doses of oxycodone. A positive correlation between tonsillitis and oxycodone doses was identified (p=0.043).

Conclusions: Our findings indicate some demographic factors may affect oxycodone use post-tonsillectomy. Moreover, many caregivers lack information on safe opioid disposal. Tonsillitis was associated with greater oxycodone usage.