O3342: Hypospadias Opioid Prescribing; Stewardship versus Security Blanket

Background: Prior research suggests post-operative pediatric opioid prescribing has been excessive, and efforts are underway to decrease unnecessary use; however, little literature exists on parental perception in this realm. We sought to investigate opioid prescribing patterns and parental satisfaction related to distal hypospadias repair.

Methods: This study was part of an institutional opioid reduction initiative. Patient data was collected in a prospective database. Male patients undergoing distal hypospadias repair from January 2024 to December 2024 were included. Patient demographics, discharge prescription details, and balancing measures were collected. All families were contacted afterward to assess opioid usage, parental perception of pain control, and satisfaction.

Results: Sixty-seven patients met inclusion criteria. The median age of 1.82 years of age (0.5-16.9 years old). Thirty-one patients received discharge opioid prescriptions. Opioid prescriptions were Oxycodone 5mg/mL at 0.1mg/kg with 5-10 doses based on surgeon preference. Of those who received opioids and responded to the survey, 4.64 mls of Oxycodone 0.1mg/kg dose was leftover. 6/30 (20 %) of families receiving discharge opioids responded to the parental satisfaction survey, with 83.3% reporting pain management satisfaction. 6/36 (17%) of families who did not receive discharge opioids responded to the parental satisfaction survey, with 83.3% reporting pain management. One (16.7%) patient in the nonopioid group required an opioid prescription to be called in.

Conclusion: Pain management and parental satisfaction were similar regardless of discharge opioid prescription. Parental requests for additional opioid prescriptions were rare. This suggests that opiates may not be needed in the majority. Despite some parents’ expectations of an opioid prescription as a security blanket, reassurance that it is not usually needed may facilitate better stewardship among urologic surgeons. The next phase of this study is an all-inclusive, no-narcotic pathway for distal hypospadias repair.