The Utilization of an Opioid-Free Anesthetic for Pediatric Circumcision in an Ambulatory Surgery Center

Circumcision is one of the most common urologic procedures performed at pediatric ambulatory centers. Emerging data on the short- and long-term effects of perioperative opioid administration has highlighted the importance of an opioid-free anesthetic regimen. We sought to evaluate the effectiveness...

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Bibliographic Details
Published in:Children (Basel) 2021-08, Vol.8 (8), p.678
Main Authors: Gilbertson, Laura E., Patel, Chhaya, De, Shuvro, Lo, Wendy, Garcia-Roig, Michael, Austin, Thomas M.
Format: Article
Language:English
Subjects:
Adults
Ambulatory care
Analgesics
circumcision
Efficiency
General anesthesia
Length of stay
Medical personnel
Narcotics
Nausea
opioid-free anesthesia
Pain
Patient satisfaction
pediatric ambulatory surgery
pediatric anesthesia
pediatric urologic surgery
Pediatrics
Penis
Surgeons
Surgery
Urology
Variables
Vomiting
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Summary:Circumcision is one of the most common urologic procedures performed at pediatric ambulatory centers. Emerging data on the short- and long-term effects of perioperative opioid administration has highlighted the importance of an opioid-free anesthetic regimen. We sought to evaluate the effectiveness of an opioid-free anesthetic in pediatric circumcision and its correlation with ambulatory surgery center efficiency. Patients, 3 years of age and younger, who underwent circumcision or circumcision revision by two surgeons pre and post introduction of an opioid-free anesthetic fast-track regimen at an outpatient surgical center were included. There were 100 patients included in this analysis, with 50 patients in each cohort. On univariate analysis, fast-tracking was associated with a decrease in median combined in-room and post-anesthesia care unit times (102.5 vs. 129.0 min, p-value < 0.001). This difference continued after multivariable analysis with an adjusted median combined in-room and post-anesthesia care unit time difference of −15.6 min (95% CI −34.2 to −12.7 min, p-value 0.018). In addition, the fast-track cohort received less intraoperative morphine equivalents without an increase in post-operative analgesic administration or change in postoperative questionnaire score. This demonstrates that opioid-free anesthesia may be used effectively in pediatric circumcision while also allowing for significant time savings for surgical centers.
ISSN:2227-9067
2227-9067
DOI:10.3390/children8080678