Opioids Provide Few Benefits To Children Following Tonsillectomy: Study

Prescribing children opioid painkillers after tonsillectomy surgery does not help reduce the risk of complications or pain, according to the findings of a new study warning against the common practice.

Children who were given OxyContin or other opioid painkillers did not have any fewer complications or reduced incidence of pain, researchers from the University of Michigan indicate in a study published last month in the medical journal JAMA Otolaryngology–Head & neck Surgery.

Nearly six in 10 children received powerful opioid painkillers after tonsil removal, such as Oxycodone and Vicodin, according to the findings. Prescriptions for children younger than 12 years old lasted an average of six to 10 days.

Many of the tonsillectomy prescriptions are prescribed preemptively to help prevent pain or complications. Yet, the findings of the new study suggest most of those prescriptions can be reduced.

Researchers analyzed claims data from the database of a large national private insurer in the U.S. from 2016 to 2017. The data included more than 15,700 children under the age of 12 who underwent tonsillectomy between April 2016 and December 2017. The average age of the children was seven years old.

More than 60% of children who had their tonsils removed were prescribed strong narcotic painkillers with one or more refills. However, children who took opioids did not experience fewer complications. They also did not experience more complications, like hemorrhage or dehydration. Similarly, they did not have fewer return doctor’s visits for pain compared to the children who underwent surgery but were not given opioids.

However, taking opioids was linked to an increased risk of return doctor’s visits for constipation, which is a common side effect of taking opioids.

Prior research has indicated prescribing children morphine, a powerful opioid, increased a child’s risk of suffering breathing problems. Opioids can depress a child’s respiratory system because children’s bodies often metabolize medication at a much faster rate than adults.

In 2013, the FDA warned doctors not to prescribe children codeine, another powerful opioid painkiller often used in cough medicines, after tonsillectomy. This warning was made after several child deaths or life-threatening respiratory depression.

Researchers noted that reducing opioid prescribing after surgery and reducing the duration of opioid prescriptions may be possible among children without increasing the risk of complications.

They concluded that focusing on reducing the number of powerful prescriptions given to children should be a priority among surgeons and doctors, especially when safe alternatives such as Tylenol can be used.