{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T23:57:30Z","timestamp":1771977450700,"version":"3.50.1"},"reference-count":29,"publisher":"Weston Medical Publishing","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Opioid Management"],"abstract":"<jats:p>Background: There is a paucity of data depicting post-operative opioid consumption in pediatric solid organ transplant (SOT) recipients, limiting ability to perform power analyses in designing prospective trials focusing on analgesia or adjuvant therapies in these populations. There is additionally unclear effect magnitude of various confounders of analgesic and sedative medications encountered in the pediatric intensive care unit (PICU).\r\nMethods: Retrospective review of pediatric patients aged 2 months-18 years at a single institution was performed on 137 SOT recipients (cardiac, liver, renal, total pancreatectomy with islet cell autotransplantation [TPIAT]) to evaluate post-operative opioid consumption in the PICU, analgesic confounders, pain scores, and opioid-related adverse effects (constipation, ileus, pruritus, nausea, urinary retention, delirium, respiratory depression, withdrawal). Values for correlative and multiplicative effect magnitude were analyzed for planned variables.\r\nResults: Average daily opioid requirement in oral morphine equivalents per kilogram was (cardiac) 12.5 (median 6.98, interquartile range [IQR] 14.3), (liver) 12.6 (median 10.1, IQR 15.3), (renal) 1.47 (median 0.614, IQR 0.95), and (TPIAT) 4.1 (median 3.44, IQR 2.6). Mechanical ventilation dependence, extracorporeal membrane oxygenation use, and open abdomen or chest demonstrated the highest correlation and effect magnitudes with opioid consumption of variables evaluated. No trends were identified for opioid-related adverse effects.\r\nConclusion: Children receiving SOT have high opioid consumption relative to many populations in the PICU. Control for and evaluation of pain confounders such as mechanical ventilation and extracorporeal membrane oxygenation should be utilized in prospective studies analyzing opioid use, adjuvant analgesics, or outcomes in critically ill transplant recipients.<\/jats:p>","DOI":"10.5055\/jom.0980","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T23:02:06Z","timestamp":1771974126000},"page":"91-110","source":"Crossref","is-referenced-by-count":0,"title":["Post-operative opioid consumption in pediatric solid organ transplant recipients: A single-site retrospective evaluation"],"prefix":"10.5055","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8204-3981","authenticated-orcid":false,"given":"Joseph C.","family":"Resch","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6735-3853","authenticated-orcid":false,"given":"Benjamin","family":"Langworthy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8916-7872","authenticated-orcid":false,"given":"Ranad","family":"Ghalban","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6788-4523","authenticated-orcid":false,"given":"Shelby","family":"Graf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5443-1258","authenticated-orcid":false,"given":"Srinath","family":"Chinnakotla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6738-6612","authenticated-orcid":false,"given":"Gwenyth","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3008","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"99893","doi-asserted-by":"crossref","unstructured":"Smith HAB, Besunder JB, Betters KA, et al.: 2022 Society of Critical Care Medicine Clinical Practice guidelines on prevention and management of pain, agitation, neuromuscular blockade, and delirium in critically ill pediatric patients with consideration of the ICU environment and early mobility. Pediatr Crit Care Med. 2022; 23(2): e74-e110.","DOI":"10.1097\/PCC.0000000000002873"},{"key":"99894","doi-asserted-by":"crossref","unstructured":"L\u00f3pez J, Botr\u00e1n M, Garc\u00eda A, et al.: Constipation in the critically ill child: Frequency and related factors. J Pediatr. 2015; 167(4): 857-861.e1. DOI: 10.1016\/j.jpeds.2015.06.046.","DOI":"10.1016\/j.jpeds.2015.06.046"},{"key":"99895","doi-asserted-by":"crossref","unstructured":"Fisher D, Grap MJ, Younger JB, et al.: Opioid withdrawal signs and symptoms in children: Frequency and determinants. Heart Lung. 2013; 42(6): 407-413. DOI: 10.1016\/j.hrtlng.2013.07.008.","DOI":"10.1016\/j.hrtlng.2013.07.008"},{"key":"99896","doi-asserted-by":"crossref","unstructured":"von Oelreich E, Eriksson M, Sj\u00f6lund KF, et al.: Opioid use after intensive care: A nationwide cohort study. Crit Care Med. 2021; 49(3): 462-471. DOI: 10.1097\/CCM.0000000000004896.","DOI":"10.1097\/CCM.0000000000004896"},{"key":"99897","doi-asserted-by":"crossref","unstructured":"Whiteside LK, Russo J, Wang J, et al.: Predictors of sustained prescription opioid use after admission for trauma in adolescents. J Adolesc Health. 2016; 58(1): 92-97.","DOI":"10.1016\/j.jadohealth.2015.08.011"},{"key":"99898","doi-asserted-by":"crossref","unstructured":"Harbaugh CM, Lee JS, Hu HM, et al.: Persistent opioid use among pediatric patients after surgery. Pediatrics. 2018; 141(1): e20172439.","DOI":"10.1542\/peds.2017-2439"},{"key":"99899","doi-asserted-by":"crossref","unstructured":"Peng K, Liu HY, Wu SR, et al.: Effects of combining dexmedetomidine and opioids for postoperative intravenous patient-controlled analgesia: A systematic review and meta-analysis. Clin J Pain. 2015; 31(12): 1097-1104. DOI: 10.1097\/AJP.0000000000000219.","DOI":"10.1097\/AJP.0000000000000219"},{"key":"99900","doi-asserted-by":"crossref","unstructured":"Licina A, Silvers A: Perioperative intravenous lidocaine infusion for postoperative analgesia in patients undergoing surgery of the spine: Systematic review and meta-analysis. Pain Med. 2022; 23(1): 45-56. DOI: 10.1093\/pm\/pnab210.","DOI":"10.1093\/pm\/pnab210"},{"key":"99901","doi-asserted-by":"crossref","unstructured":"Na HS, Lee JH, Hwang JY, et al.: Effects of magnesium sulphate on intraoperative neuromuscular blocking agent requirements and postoperative analgesia in children with cerebral palsy. Br J Anaesth. 2010; 104(3): 344-350. DOI: 10.1093\/bja\/aep379.","DOI":"10.1093\/bja\/aep379"},{"key":"99902","doi-asserted-by":"crossref","unstructured":"Hutchins J, Castro C, Wang Q, et al.: Postoperative pain control with paravertebral catheters after pediatric total pancreatectomy and islet autotransplantation: A retrospective cohort study. Paediatr Anaesth. 2016; 26(3): 315-320. DOI: 10.1111\/pan.12840.","DOI":"10.1111\/pan.12840"},{"key":"99903","doi-asserted-by":"crossref","unstructured":"Batko I, Kos\u00b4cielniak-Merak B, Tomasik PJ, et al.: Lidocaine as an element of multimodal analgesic therapy in major spine surgical procedures in children: A prospective, randomized, double-blind study. Pharmacol Rep. 2020; 72(3): 744-755. DOI: 10.1007\/s43440-020-00100-7.","DOI":"10.1007\/s43440-020-00100-7"},{"key":"99904","doi-asserted-by":"crossref","unstructured":"Mun-Price C, Than K, Klein MJ, et al.: The effect of anesthesia without opioid on perioperative opioid demand in children with severe obstructive sleep apnea (OSA) for adenotonsillectomies\u2014Single-center retrospective observational study. JA Clin Rep. 2022; 8(1): 41. DOI: 10.1186\/s40981-022-00530-7.","DOI":"10.1186\/s40981-022-00530-7"},{"key":"99905","doi-asserted-by":"crossref","unstructured":"Nielsen S, Degenhardt L, Hoban B, et al.: A synthesis of oral morphine equivalents (OME) for opioid utilization studies. Pharmacoepidemiol Drug. 2016; 25(6): 733-737. DOI: 10.1002\/pds.3945.","DOI":"10.1002\/pds.3945"},{"key":"99906","doi-asserted-by":"crossref","unstructured":"Gewandter JS, Smith SM, Dworkin RH, et al.: Research approaches for evaluating opioid sparing in clinical trials of acute and chronic pain treatments: Initiative on methods, measurement, and pain assessment in clinical trials recommendations. Pain. 2021; 162(11): 2669-2681. DOI: 10.1097\/j.pain.0000000000002283.","DOI":"10.1097\/j.pain.0000000000002283"},{"key":"99907","doi-asserted-by":"crossref","unstructured":"Gilron I, Carr DB, Desjardins PJ, et al.: Current methods and challenges for acute pain clinical trials. Pain Rep. 2019; 4(3): e647. DOI: 10.1097\/PR9.0000000000000647.","DOI":"10.1097\/PR9.0000000000000647"},{"key":"99908","doi-asserted-by":"crossref","unstructured":"Brewster R, Wong M, Magnani CJ, et al.: Early discontinuation, results reporting, and publication of pediatric clinical trials. Pediatrics. 2022; 149(4): e2021052557. DOI: 10.1542\/peds.2021-052557.","DOI":"10.1542\/peds.2021-052557"},{"key":"99909","doi-asserted-by":"crossref","unstructured":"Bourgeois FT, Murthy S, Pinto C, et al.: Pediatric versus adult drug trials for conditions with high pediatric disease burden. Pediatrics. 2012; 130(2): 285-292. DOI: 10.1542\/peds.2012-0139.","DOI":"10.1542\/peds.2012-0139"},{"key":"99910","doi-asserted-by":"crossref","unstructured":"Shaheen PE, Walsh D, Lasheen W, et al.: Opioid equianalgesic tables: Are they all equally dangerous? J Pain Symptom Manage. 2009; 38(3): 409-417. DOI: 10.1016\/j.jpainsymman.2009.06.004.","DOI":"10.1016\/j.jpainsymman.2009.06.004"},{"key":"99911","doi-asserted-by":"crossref","unstructured":"Dowell D, Ragan KR, Jones CM, et al.: CDC clinical practice guideline for prescribing opioids for pain\u2014United States, 2022. MMWR Recomm Rep. 2022; 71(3): 1-95. DOI: 10.15585\/mmwr.rr7103a1.","DOI":"10.15585\/mmwr.rr7103a1"},{"key":"99912","unstructured":"US Department of Health and Human Services: Opioid oral morphine milligram equivalent (MME) conversion factors table for prescription drug coverage. USDHhs guidance portal. 2020. Available at https:\/\/www.hhs.gov\/guidance\/document\/opioidoral-morphine-milligram-equivalent-mme-conversion-factors-0. Accessed September 12, 2024."},{"key":"99913","doi-asserted-by":"crossref","unstructured":"McGrath PJ, Walco GA, Turk DC, et al.: PedIMMPACT: Core outcome domains and measures for pediatric acute and chronic\/recurrent pain clinical trials: PedIMMPACT recommendations. J Pain. 2008; 9(9): 771-783. DOI: 10.1016\/j.jpain.2008.04.007.","DOI":"10.1016\/j.jpain.2008.04.007"},{"key":"99914","doi-asserted-by":"crossref","unstructured":"Walco GA, Kopecky EA, Weisman SJ, et al.: Clinical trial designs and models for analgesic medications for acute pain in neonates, infants, toddlers, children, and adolescents: ACTTION recommendations. Pain. 2018; 159(2): 193-205. DOI: 10.1097\/j.pain.0000000000001104.","DOI":"10.1097\/j.pain.0000000000001104"},{"key":"99915","doi-asserted-by":"crossref","unstructured":"Karlsen APH, Pedersen C, Laigaard J, et al.: Opioid consumption as a core outcome domain in postoperative pain management. Pain. 2022; 163(6): e786-e787. DOI: 10.1097\/j.pain.0000000000002581.","DOI":"10.1097\/j.pain.0000000000002581"},{"key":"99916","doi-asserted-by":"crossref","unstructured":"Berde CB, Walco GA, Krane EJ, et al.: Pediatric analgesic clinical trial designs, measures, and extrapolation: Report of an FDA scientific workshop. Pediatrics. 2012; 129(2): 354-364. DOI: 10.1542\/peds.2010-3591.","DOI":"10.1542\/peds.2010-3591"},{"key":"99917","doi-asserted-by":"crossref","unstructured":"Cho HK, Park IJ, Yoon HY, et al.: Efficacy of adjuvant magnesium for posttonsillectomy morbidity in children: A metaanalysis. Otolaryngol-Head Neck Surg. 2018; 158(1): 27-35. DOI: 10.1177\/0194599817730354.","DOI":"10.1177\/0194599817730354"},{"key":"99918","doi-asserted-by":"crossref","unstructured":"Heath C, Hii J, Thalayasingam P, et al.: Perioperative intravenous lidocaine use in children. Paediatr Anaesth. 2023; 33(5): 336-346. DOI: 10.1111\/pan.14608.","DOI":"10.1111\/pan.14608"},{"key":"99919","doi-asserted-by":"crossref","unstructured":"Ha MA, Sieg AC: Evaluation of altered drug pharmacokinetics in critically ill adults receiving extracorporeal membrane oxygenation. Pharmacotherapy. 2017; 37(2): 221-235. DOI: 10.1002\/phar.1882.","DOI":"10.1002\/phar.1882"},{"key":"99920","doi-asserted-by":"crossref","unstructured":"Mularski RA, White-Chu F, Overbay D, et al.: Measuring pain as the 5th vital sign does not improve quality of pain management. J Gen Intern Med. 2006; 21(6): 607-612. DOI: 10.1111\/j.1525-1497.2006.00415.x.","DOI":"10.1111\/j.1525-1497.2006.00415.x"},{"key":"99921","doi-asserted-by":"crossref","unstructured":"van Dijk JF, Kappen TH, Schuurmans MJ, et al.: The relation between patients\u2019 NRS pain scores and their desire for additional opioids after surgery. Pain Pract. 2015; 15(7): 604-609. DOI: 10.1111\/papr.12217.","DOI":"10.1111\/papr.12217"}],"container-title":["Journal of Opioid Management"],"original-title":[],"link":[{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/download\/3981\/4265","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/download\/3981\/4265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T23:02:16Z","timestamp":1771974136000},"score":1,"resource":{"primary":{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/jom\/article\/view\/3981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,1]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,2,24]]}},"URL":"https:\/\/doi.org\/10.5055\/jom.0980","relation":{},"ISSN":["1551-7489","1551-7489"],"issn-type":[{"value":"1551-7489","type":"electronic"},{"value":"1551-7489","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,1]]}}}