Opioids After Appendectomy Are Associated With Longer Hospital Stay for Children

For children who underwent appendectomy for perforated appendicitis, postoperative hospital stays were longer with early and continued postoperative opioid use, according to a retrospective cohort study.

“Minimizing opioid use, even on postoperative day 2, may result in a decreased postoperative duration of stay,” wrote the researchers from Children’s Hospital Los Angeles and the University of Southern California.

The researchers looked at postoperative opioid use and outcomes for 47,726 children, aged 2 through 18 years, with perforated appendicitis who underwent appendectomy. The study was based on data from the Pediatric Health Information System database for the years 2005 through 2015.

Among the children, 17.7% received nonopioid analgesics alone, 77.6% received opioids, and 4.7% received no analgesics on postoperative day 1, the researchers reported.

Opioid use on postoperative day 1 was associated with a 0.75-day longer postoperative stay, the researchers found, and starting opioids after postoperative day 1 was associated with a 2.21-day longer postoperative stay.

For children who received opioids on postoperative day 1, continued opioid use after postoperative day 1 was associated with a 1.88-day longer postoperative stay, the researchers reported.

Opioid use on postoperative day 1 did not, however, affect 30-day readmissions, the researchers found.

—Jolynn Tumolo

Reference:

Mahdi EM, Ourshalimian S, Russell CJ, Zamora AK, Kelley-Quon LI. Fewer postoperative opioids are associated with decreased duration of stay for children with perforated appendicitis. Surgery. 2020;168(5):942-947. https://doi.org/10.1016/j.surg.2020.04.060