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Oxycodone is a commonly used oral opioid in children for treating postoperative pain. Highly polymorphic gene metabolizes oxycodone into its more potent metabolite, oxymorphone. We hypothesized that altered activity due to polymorphisms will influence oxycodone requirements {relative oxycodone use [oxycodone morphine equivalents (MEq)/total MEq] to maintain analgesia} (primary outcome) and risk for oxycodone induced side-effects such as respiratory depression (RD) and emesis (secondary outcomes). We also explored the influence of genotype availability and provider guidance on oral opioid prescription patterns.