Transitioning to Opioid-free Anesthesia for Pediatric Supracondylar Fracture Repairs: A Patient Safety Report
2025

Opioid-free Anesthesia for Pediatric Fracture Repairs

Sample size: 1280 publication Evidence: moderate

Author Information

Author(s): Henson Laurence O. MD, MPH, Chiem Jennifer MD, Joseph Emmanuella MD, MPH, Patrao Fiona MD, Low Daniel King-Wai MD

Primary Institution: University of Washington, Seattle Children's Hospital

Hypothesis

Can opioid-free anesthesia provide similar postoperative outcomes compared to traditional opioid-based anesthesia for pediatric supracondylar fracture repairs?

Conclusion

The transition to opioid-free anesthesia resulted in similar pain management outcomes with a reduced rate of postoperative nausea and vomiting.

Supporting Evidence

  • The opioid group had a mean maximum pain score of 3.39, while the OFA group had a mean of 3.70.
  • The PACU IV opioid rescue rate was 38.82% for the opioid group and 38.73% for the OFA group.
  • The PONV rescue rate was 1.53% for the opioid group and 0.23% for the OFA group.
  • Mean PACU length of stay was 79 minutes for the opioid group and 86 minutes for the OFA group.

Takeaway

Doctors tried a new way to give anesthesia without opioids for kids with broken arms, and it worked just as well but made them feel less sick afterward.

Methodology

The study compared outcomes of pediatric patients undergoing supracondylar fracture repairs with opioid-free anesthesia versus those receiving opioids.

Potential Biases

Variability in clinician practices and staff turnover may introduce bias in the results.

Limitations

The study relied on real-world data without adjusting for confounders and had variability in the implementation of the opioid-free protocol.

Participant Demographics

{"age_groups":{"infant":"0.65%","toddler":"12.5%","preschool":"27.37%","childhood":"54.31%","adolescence":"5.17%"},"sex":{"male":"50.86%","female":"48.92%"},"race":{"non_hispanic_white":"50.86%","hispanic":"13.36%","asian":"12.07%"}}

Digital Object Identifier (DOI)

10.1097/pq9.0000000000000777

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