{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:56:35Z","timestamp":1791489395029,"version":"4.3.4"},"reference-count":11,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study analyzes pediatric plastic surgery outpatient opioid prescribing rates at a single institution that implemented Enhanced Recovery After Surgery (ERAS) protocols with the national average.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective analysis was performed using the 2023 ACS NSQIP Pediatric Opioid Stewardship Report.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>The study was conducted at a single academic pediatric hospital participating in the ACS NSQIP Pediatric registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/Participants<\/jats:title>\n                    <jats:p>Pediatric patients who underwent common plastic surgery procedures between January 1 and December 31, 2023, as reported by NSQIP, were included. This comprised 146 patients from the study institution and 10\u2005557 patients from 157 other NSQIP-participating hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>ERAS protocols emphasizing non-opioid multimodal analgesia were implemented in 2018. No outpatient opioids were prescribed for cleft lip repair, cranial spring placement\/removal, or mandibular distraction osteogenesis. For more invasive procedures, patients received 3 doses of oral oxycodone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>The primary outcome is the rate of outpatient opioid prescribing at the study institution compared to the national average, stratified by age group (adolescents, children, infants\/small children, and neonates).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study institution had a significantly lower prescribing rate (10.96%) versus the national average (51.81%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.000001). By age group: adolescents (23.81% vs 63.20%), children (5.88% vs 52.82%), and infants\/small children (6.45% vs 45.85%), all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.000001. No neonates at the study site received opioids, compared to 13.83% nationally (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.566).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ERAS protocol implementation is associated with a significant reduction in outpatient opioid prescribing. Broader adoption may improve opioid stewardship in pediatric plastic surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261432956","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T17:27:48Z","timestamp":1773768468000},"page":"3852-3856","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhanced Recovery After Surgery Protocols Can Vastly Decrease Rates of Outpatient Opiate Prescribing in Pediatric Plastic Surgery Patients"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8404-240X","authenticated-orcid":false,"given":"Samantha Diane","family":"Morin","sequence":"first","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1644-2834","authenticated-orcid":false,"given":"Colton","family":"Fernstrum","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laxmi","family":"Dhungel","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura S.","family":"Humphries","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8332-2280","authenticated-orcid":false,"given":"Ian C.","family":"Hoppe","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.21037\/tgh-20-188"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-018-0905-1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpra.2021.10.006"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-014-0272-0"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjae.2020.03.004"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656241255940"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-2439"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2020.5045"},{"key":"e_1_3_2_10_2","unstructured":"ACS National Surgical Quality Improvement Program Pediatric. 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Accessed March 15 2025. https:\/\/www.facs.org\/quality-programs\/data-and-registries\/pediatric\/"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2021.12.008"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000003951"}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656261432956","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10556656261432956","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656261432956","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:30:11Z","timestamp":1791487811000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10556656261432956"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":11,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/10556656261432956"],"URL":"https:\/\/doi.org\/10.1177\/10556656261432956","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]}}}