PEDIATRICS· 2012Q1
More Codeine Fatalities After Tonsillectomy in North American Children
- 384citations
- Q1SCImago
- 2012year
Short summary
Codeine use after tonsillectomy is unsafe for young children with obstructive sleep apnea syndrome, with three additional fatal or life-threatening cases reported in North America following an initial 2009 report.
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Key points
- Three additional fatal or life-threatening cases of codeine use post-adenotonsillectomy in North American children are reported.
- Two fatal cases were attributed to genetic CYP2D6 gene duplications leading to excessive morphine production from codeine.
- A severe respiratory depression case occurred in an extensive metabolizer.
- Codeine and other CYP2D6-metabolized opioids pose risks for young children with obstructive sleep apnea syndrome after adenotonsillectomy.
AI-generated from the title and abstract; the full text is not read.
Abstract
In 2009 we reported the fatal case of a toddler who had received codeine after adenotonsillectomy for obstructive sleep apnea syndrome. The child was an ultra-rapid metabolizer of cytochrome P4502D6 (CYP2D6). We now report 3 additional fatal or life-threatening cases from North America. In the 2 fatal cases, functional gene duplications encoding for CYP2D6 caused a significantly greater production of potent morphine from its parent drug, codeine. A severe case of respiratory depression in an extensive metabolizer is also noted. These cases demonstrate that analgesia with codeine or other opioids that use the CYP2D6 pathway after adenotonsillectomy may not be safe in young children with obstructive sleep apnea syndrome.
The authors' abstract, as published at the source. PEDIATRICS, 2012 · DOI ↗
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Field: Anesthesiology and Pain Medicine
Anesthesiology and Pain MedicineMedicine