More than 50 percent of children who undergo umbilical hernia repair are given opioids after surgery, according to new findings by a research team at the University of Wisconsin School of Medicine and Public Health.
The team, headed by pediatric surgeon Jonathan Emerson Kohler, MD, looked at a national database of nearly 4400 cases of children who underwent simple umbilical (belly button) hernia repair. They found that 52 percent of the patients filled prescriptions for opioids. Kohler said the rate of prescribing opioids for uncomplicated umbilical hernia repair significantly increased from 2011 to 2014, with a modest decline in 2015. The study, published in the journal Surgery, predates the most recent public policy debate on the opioid epidemic.
“The American College of Surgeons and almost half of the surgeons in this study suggest that parents should expect their children to do fine with non-narcotic pain relievers after surgery for umbilical hernias,” said Dr. Kohler. “This study suggests that best-practice guidelines could be developed and disseminated to reduce opioid prescriptions for uncomplicated umbilical hernia surgery and other common procedures.”
The most common medications prescribed were hydrocodone with acetaminophen, codeine with acetaminophen and oxycodone with acetaminophen.
The database review showed filled prescriptions for opioids varied widely among regions of the United States. The South showed the highest rate (59 percent) followed by the Midwest at 50 percent. The western United States had a rate of 43 percent and the Northeast was lowest at 41 percent. Perhaps most concerning, six percent of children who filled a prescription for opioids went on to fill another prescription for opioids, suggesting chronic use.
“Not only can pediatric patients suffer respiratory depression from opioids, but unused opioids can be diverted, or misused. Misused opioids are most commonly obtained free from friends and family,” said Kohler.
Kohler said guidelines for appropriate prescribing of opioids after common, simple procedures could improve the quality of care for children and impact the U.S. epidemic of opioid abuse.