The impact of patient age and procedure type on postoperative opioid use following ambulatory pediatric urologic procedures

Purpose The aim of this study is to determine whether patient age and procedure type are associated with duration of opioid use in pediatric patients undergoing ambulatory urologic procedures. Methods We retrospectively reviewed pediatric patients who underwent outpatient urologic procedures from 2013 to 2017. At postoperative visits, parents reported the number of days their child took opioid pain medication. Factors associated with duration of opioid use were evaluated using negative binomial regression models. Results 805 patients were included: 320 infants (39.8%), 430 children (53.4%), and 55 adolescents (6.8%). Overall mean length of opioid use was 1.7 (± 2.6) days. On average, infants used opioids for the shortest duration: 1.5 (± 2.3) days, followed by children: 1.7 (± 2.5) days, and adolescents: 3.1 (± 4.6) days. In adjusted models, adolescents used opioids for 85.2% longer (95% CI 13.1–161.8%; p < 0.001) than children and infants used opioids for 19.4% shorter duration (95% CI 0.4–34.7%; p = 0.05) than children. Each 1-year increase in age was associated with 6.1% increased duration of opioid use (95% CI 3.9–8.5%; p < 0.0001). Patients who underwent circumcision, hypospadias repair, and penile reconstruction took opioids for 75.9% (95% CI 42.6–117.1%; p < 0.001), 144.2% (95% CI 76.4–238.0%; p < 0.001), and 126.7% (95% CI 48.8–245.3%; p < 0.001) longer respectively than patients who underwent inguinal procedures. Conclusions Increasing age, circumcision, hypospadias repair, and penile reconstruction are associated with increased duration of opioid use.