# Safety Assessment of Perioperative Pain Medications for Children (SAPPhire)

> **NIH NIH R21** · NORTHWESTERN UNIVERSITY · 2022 · $200,010

## Abstract

PROJECT ABSTRACT
 Per capita opioid prescribing is higher in the US than in any other nation and the opioid crisis affects not
only adults, but, also children and adolescents. Despite increases in pediatric hospitalizations related to opioid
poisonings and opioid-related critical care unit admissions, yet, opioid use in children is understudied and
underestimated. This gap in research is alarming given that drug use impairs child brain development and use
of prescription opioids during childhood/early adolescence is a risk factor for prescription opioid misuse. One
path to childhood opioid misuse begins with exposure after surgery for pain control and more than 2 million
children undergo surgery in the US each year. Evidence also suggests that pediatric surgeons often prescribe
more opioids than necessary following minor procedures with more than 50% of prescribed pills remaining
unused, and resulting in excess opioids being stored in homes with children and, thus, becoming accessible for
nonmedical use.
 Currently, no comprehensive data source exists that catalogues pediatric surgery perioperative pain
management practices, including pain medication prescribing and that also assesses pain control, both of
which are necessary to develop evidence-based recommendations for pediatric surgery perioperative pain
management. This project, Safety Assessment of Perioperative Pain Medications for Children (SAPPhire),will
create this unique data source to study, understand, and improve current pediatric surgery perioperative pain
management, by combining data about current pain management practices (e.g., local anesthetics, regional
nerve blocks, non-opioid analgesics, and pediatric-specific opioid prescribing practices), with patient-level
demographic, health (e.g., comorbid conditions, surgical procedure), and outcomes (e.g., length of stay,
surgical-site infections, and readmission) data from the American College of Surgeons (ACS) National Surgical
Quality Improvement Program-Pediatric (NSQIP-P). In addition, post-discharge opioid use and patient reported
outcomes (PROs) on pain control and limitations of daily activities will be collected. Combined, these data will
guide feedback and interventions to address surgeon- and hospital-level pain management practice variation
and identify high “opioid-use” procedures and high “opioid-exposed” subgroups of pediatric surgical patients.
The study will also assess adherence to FDA opioid medication contraindications and warnings. This formative
study will provide essential information needed to develop pediatric procedure- and patient-specific guidelines
for pain management. Lessons learned from SAPPhire will facilitate wider adoption of perioperative pain
management practices across to the >150 NSQIP-P hospitals across the United States.

## Key facts

- **NIH application ID:** 10472724
- **Project number:** 5R21HD104078-02
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Mehul V. Raval
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $200,010
- **Award type:** 5
- **Project period:** 2021-08-20 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10472724

## Citation

> US National Institutes of Health, RePORTER application 10472724, Safety Assessment of Perioperative Pain Medications for Children (SAPPhire) (5R21HD104078-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10472724. Licensed CC0.

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