Association of Postnatal Opioid Exposure and 2-Year Neurodevelopmental Outcomes in Infants Undergoing Cardiac Surgery.

Background: Opioids are commonly used to provide analgesia during and after congenital heart surgery. The effects of exposure to opioids on neurodevelopment in neonates and infants are not well understood.

Objectives: This study sought to evaluate the associations between cumulative opioid exposure (measured in morphine mg equivalent) over the first year of life and 2-year neurodevelopmental outcomes (Bayley Scales of Infant and Toddler Development-Third/Fourth Edition [Bayley-III/IV] cognitive, language, and motor scores).

Preoperative vs Postoperative Opioid Prescriptions and Prolonged Opioid Refills Among US Youths.

Importance: High-risk practices, including dispensing an opioid prescription before surgery when not recommended, remain poorly characterized among US youths and may contribute to new persistent opioid use.

Objective: To characterize changes in preoperative, postoperative, and refill opioid prescriptions up to 180 days after surgery.

Design, Setting, And Participants: This retrospective cohort study was performed using national claims data to determine opioid prescribing practices among a cohort of opioid-naive youths aged 11 to 20 years undergoing 22 inpatient and outpatient surgical procedures between 2015 and 2020.

Predicting pediatric emergence delirium using data-driven machine learning applied to electronic health record dataset at a quaternary care pediatric hospital.

Objectives: Pediatric emergence delirium is an undesirable outcome that is understudied. Development of a predictive model is an initial step toward reducing its occurrence. This study aimed to apply machine learning (ML) methods to a large clinical dataset to develop a predictive model for pediatric emergence delirium.

Impact of Ketorolac on Reoperation for Hemorrhage After Pediatric Tonsillectomy: A Single-Center Retrospective Propensity-Matched Study.

Objective: To determine if perioperative ketorolac is associated with an increased rate of reoperation for hemorrhage after pediatric tonsillectomy at 30 days and 48 hours.

Study Design: Single-center retrospective propensity-matched study.

Setting: Quaternary pediatric hospital and ambulatory surgery center.

Trends in Routine Opioid Dispensing After Common Pediatric Surgeries in the United States: 2014-2019.

Using Joinpoint regression, our study revealed substantial decreases in postoperative opioid dispensing after outpatient pediatric surgeries beginning in 2017.

Association of the 2016 US Centers for Disease Control and Prevention Opioid Prescribing Guideline With Changes in Opioid Dispensing After Surgery.

Importance: While the 2016 US Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids for chronic pain was not intended to address postoperative pain management, observers have noted the potential for the guideline to have affected postoperative opioid prescribing.

Objective: To assess changes in postoperative opioid dispensing after vs before the CDC guideline release in March 2016.

Design, Setting, And Participants: This cross-sectional study included 361 556 opioid-naive patients who received 1 of 8 common surgical procedures between March 16, 2014, and March 15, 2018.

Cost-Effectiveness Research in Anesthesiology.

Perioperative interventions aimed at decreasing costs and improving outcomes have become increasingly popular in recent years. Anesthesiologists are often faced with a choice among different treatment strategies with little data available on the comparative cost-effectiveness. We performed a systematic review of the English language literature between 1980 and 2014 to identify cost-effectiveness analyses of anesthesiology and perioperative medicine interventions.

How much is a kidney worth? Cost-effectiveness of routine imaging after ureteroscopy to prevent silent obstruction.

Purpose: The 2012 American Urological Association (AUA) Clinical Effectiveness Protocols for Imaging in the Management of Ureteral Calculous Disease recommends routine postoperative imaging after ureteroscopy. We evaluated the cost-effectiveness of routine postoperative imaging after ureteroscopy.

Materials And Methods: We searched the literature to determine the risk of complications after routine ureteroscopy for stones, including the incidence of postoperative pain, stricture and silent obstruction.