Outpatient Opioid Monitoring and Reclamation Following Minimally Invasive Repair of Pectus Excavatum.

Introduction: To decrease diversion of unused opioids following the minimally invasive repair of pectus excavatum (MIRPE), we developed an opioid education monitoring and reclamation program. The aim was to evaluate outpatient opioid use and disposal following MIRPE.

Materials And Methods: A retrospective review was conducted at a single center among patients <19 ys who underwent MIRPE with intercostal nerve cryoablation. Demographic and clinical data, including outpatient opioid prescriptions, were reviewed. Patients or families were educated on the risk of opioids and encouraged to bring unused opioid to the first postoperative visit for disposal. Questionnaires were administered on opioid use and disposal plan.

Results: A total of 72 patients participated in the program: 83.3% (60/72) were male, and the mean age was 15.2 ± 1.6 ys old. A median of 10 tablets per patient were prescribed, with a total of 790 five-mg oxycodone tablets prescribed. Prior to the first postoperative visit, 20.8% (15/72) of patients required an opioid refill. Patients reported using a median of 5 [IQR: 1.6 - 10], five-mg oxycodone tablets for a median of 5 [IQR: 2 - 6.7] ds: 92% (65/72) had unused opioids totaling 420 tablets. Of patients with unused opioid, 50.8% (33/65) reported a plan for opioid disposal, 30.8% (20/65) reported a plan to keep unused opioids, and 28.5% (12/65) did not disclose a plan of disposal.

Conclusions: Despite conservative opioid prescribing, 53% of outpatient opioids go unused following MIRPE. After education on opioid risks and providing a convenient means for safe opioid disposal, half of the patients or families intended to dispose of unused opioids.