Assessing opioid administration in pediatric burn patients with nonsurgical management. Issue 2 (March 2021)

• Record Type: Journal Article
• Authors: Richards, Holden W.; Shi, Junxin; Thakkar, Rajan K.; Giles, Sheila; Wheeler, Krista K.; Fabia, Renata
• Is Part Of: Burns. Volume 47:Issue 2(2021)
• Page Start: 322
• Page End: 326
• Publication Date: 2021-03
• Subjects: Pediatric pain -- Trends -- Opioids -- Pain management -- Burn analgesia -- Nonsurgical burn management; Burns and scalds -- Periodicals; 617.11
• DOI: 10.1016/j.burns.2020.11.014
• Languages: English
• ISSNs: 0305-4179

Abstract

Highlights: There is a downward trend of opioid analgesia in pediatric burn patients. Older and larger TBSA burn patients show increases in opioid utilization. There are no disparities in opioid use by burn depth, sex, or race and ethnicity. Abstract: Background: Despite the vast literature studying the opioid crisis, sparse data describe this in the pediatric burn population. This study sought to assess patient-level characteristics and their potential effects on opioid administration in nonsurgical pediatric burn inpatients. Methods: Admitted burn patients from 2013 to 2018 with nonsurgical management at an American Burn Association (ABA) verified pediatric burn center were retrospectively identified. Morphine milligram equivalents by weight (MME/kg) per admission were evaluated through a multiple loglinear regression with race, sex, age, total body surface area burned (TBSA), and burn depth as predictors. Simple linear regression was used to evaluate the temporal trend of median opioid utilization. Results: A total of 806 patients (55% White, 35% Black, 5% Hispanic, 5% Other) were included. In an adjusted analysis, no differences in opioid administration were seen by sex, burn degree, or for Blacks and Hispanics when compared with Whites. Increased MME/kg was associated with older age (10–18 years; p < 0.0001) and larger burns (>5% TBSA burned; p < 0.0001). From 2013 to 2018, median MME/kg per admission declined significantly (2013:0.21, 2018:0.09; p = 0.0103). Conclusions: Nonsurgical burn patients who were older and presented with larger TBSA experienced marked increases in opioid utilization. Overall, opioid administration decreased over time.