Plast Reconstr Surg Glob OpenPlast Reconstr Surg Glob OpenGOXPlastic and Reconstructive Surgery Global Open2169-7574Wolters Kluwer Health53612960001210.1097/01.GOX.0000513385.58709.27AAPS 2017 Abstract SupplementAbstract P11. Craniosynostosis Surgery: A Painless Procedure? A Single Institution’s Experience in Post-operative Pain ManagementMacmillanAlexandraMBBSKattailDeepaM.D.FaatehMuhammadMBBSPedreiraRachelBAMusaviLeilaBAChoReginaBSLopezJosephM.D. MBADorafsharAmir H.MbChB.Johns Hopkins Hospital, Baltimore, M.D., USA.22017083201752 SupplAAPS 2017 Abstract Supplement6Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.2017This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.OPEN-ACCESSTRUEPurpose: Craniosynostosis is an extremely complex, invasive procedure often assumed to be associated with minimal pain. The purpose of this study was to investigate pain management trends at a tertiary academic institution.
Methods: Retrospective chart review was performed of all surgical repairs for primary craniosynostosis at The Johns Hopkins Hospital from January 2009 to May 2013. Demographic information, admission data, and post-operative pain management were recorded.
Results: 57 patients were identified. Mean age was 12.6 months, mean length of stay was 3.2 days. 86% were admitted to ICU, the remainder admitted to an inpatient floor. 93% were prescribed IV parent/nurse controlled analgesia (PCA), with fentanyl (73.6%) being most utilized. 98.3% were prescribed acetaminophen. No patients received NSAIDs. 98.3% were prescribed enteral opioids and oxycodone was the only opioid utilized. Transition from IV to enteral opioids occurred on post-operative day (POD) 0–2 in 45.6%, day 2–3 in in 52.7%, and after day 4 in 1.8%. 89.3% were prescribed opioids for discharge, most commonly oxycodone.
Conclusion: Despite pain service consultation and immediate initiation of IV PCA use, over 40% of patients were transitioned to oral opioids by POD 1 and mean length of stay was 3 days. Our results indicate that utilization of opioids via PCA can provide effective pain control without delaying transition to oral analgesics or discharge to home.