I read with great interest the article by Cartmill et al.
1The authors performed a retrospective national analysis of pediatric patients undergoing umbilical hernia repair and concluded that, although many patients do not require opioids for umbilical hernia repair, most pediatric patients fill opioid prescriptions, including for prolonged courses and refills. The authors should be applauded for performing a well-designed study on an important topic (eg, acute pain) in patients undergoing surgery.
- Cartmill R.S.
- Yang D.Y.
- Fernandes-Taylor S.
- Kohler J.E.
National variation in opioid prescribing after pediatric umbilical hernia repair.
Surgery. 2019; 165: 838-842
- Morozumi K.
- Takahashi H.
- Suzuki T.
Distal adductor canal block for administering postoperative analgesia in lower limb surgery.
J Clin Anesth. 2018; 44: 44
3The need to reduce postoperative opioid prescriptions is an important public health issue in perioperative medicine.
- Gerrish A.W.
- Fogel S.
- Lockhart E.R.
- Nussbaum M.
- Adkins F.
Opioid prescribing practices during implementation of an enhanced recovery program at a tertiary care hospital.
Surgery. 2018; 164: 674-679
- Ueshima H.
- Otake H.
Clinical experiences of erector spinae plane block for children.
J Clin Anesth. 2018; 44: 41
- Bamgbade O.A.
Magnesium suprascapular nerve block for the management of painful shoulder disorders.
J Clin Anesth. 2018; 44: 48-49
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- National variation in opioid prescribing after pediatric umbilical hernia repair.Surgery. 2019; 165: 838-842
- Distal adductor canal block for administering postoperative analgesia in lower limb surgery.J Clin Anesth. 2018; 44: 44
- Opioid prescribing practices during implementation of an enhanced recovery program at a tertiary care hospital.Surgery. 2018; 164: 674-679
- Clinical experiences of erector spinae plane block for children.J Clin Anesth. 2018; 44: 41
- Magnesium suprascapular nerve block for the management of painful shoulder disorders.J Clin Anesth. 2018; 44: 48-49
- Evaluation of the analgesia nociception index for monitoring intraoperative analgesia in children.Br J Anaesth. 2018; 121: 462-468
Published online: March 27, 2019
Accepted: February 12, 2019
© 2019 Elsevier Inc. All rights reserved.
ScienceDirectAccess this article on ScienceDirect
- National variation in opioid prescribing after pediatric umbilical hernia repairSurgeryVol. 165Issue 4
- Reply to: Confounding factors on the analysis of opioid prescription after pediatric umbilical hernia repairSurgeryVol. 166Issue 2
- PreviewWe thank Dr. Argo for his interest and for his thoughtful comments on our work.1 There is unquestionably a role for perioperative nonopioid analgesia in reducing the use of opioids after surgery. Although the amount of tissue disruption in pediatric umbilical hernias is generally minimal and local anesthetic and nonnarcotic oral analgesics are—in our experience—highly effective, more sophisticated techniques, such as regional nerve blocks, are increasingly being used in both pediatric and adult surgery.