Format

Send to

Choose Destination
Laryngoscope Investig Otolaryngol. 2018 Dec 28;4(1):165-169. doi: 10.1002/lio2.237. eCollection 2019 Feb.

Pediatric emergency department visits for uncontrolled pain in postoperative adenotonsillectomy patients.

Author information

1
Division of Pediatric Otolaryngology-Head and Neck Surgery Ann & Robert H. Lurie Children's Hospital of Chicago Chicago Illinois.
2
Department of Otolaryngology-Head and Neck Surgery Northwestern University Feinberg School of Medicine Chicago Illinois.
3
Department of Nursing Ann & Robert H. Lurie Children's Hospital of Chicago Chicago Illinois.
4
Department of Pediatrics Northwestern University Feinberg School of Medicine Chicago Illinois.
5
Department of Surgery Ann & Robert H. Lurie Children's Hospital of Chicago Chicago Illinois.
6
Division of Pediatric Surgery Ann & Robert H. Lurie Children's Hospital of Chicago Chicago Illinois.

Abstract

Objective:

Identify demographic variables related to emergency department (ED) returns, and analgesic administration in the ED for postoperative pain after adenotonsillectomy (T&A).

Study Design:

Pediatric Health Information System (PHIS) database analysis.

Methods:

Forty-seven children's hospitals included in the PHIS database were queried for all ED visits within 30 days of surgery with a diagnosis of acute postoperative pain (n = 2459) from 2014 to 2015. The subset of postoperative T&A patients (n = 861) was further analyzed for variables associated with return, and for pain management strategies, specifically opioids, employed by the ED.

Results:

Of the 2459 pediatric patients returning to the ED for acute postoperative pain, the largest subset included T&A patients (n = 861, 35%). Patients were seen an average of 4 days (SD 2.4) after their surgery. ED administration of opioids was not associated with gender, race, surgical diagnosis, or ethnicity. The rate of opioid administration by the ED increased with advancing age of the children analyzed (P = .01). The incidence was also higher for those with commercial versus Medicaid insurance carriers. A total of 204 (23.7%) patients received opioids while in the ED, 439 (51%) received both opioids and non-opioids, and only 51 (5.9%) received no pain medication.

Conclusion:

T&A patients make up the largest subset of patients returning to the ED for postoperative pain. A total of 74.7% of patients receive opioids, either alone or in combination with non-opioids, on return to the ED. ED opioid administration was associated with older age of the child and payer, but not with gender, race, surgical diagnosis, or ethnicity.

Level of Evidence:

4.

KEYWORDS:

PHIS database; Pediatric adenotonsillectomy; adenotonsillectomy complications; adenotonsillectomy pain

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center