Reference: In response to Sutters KA et al.'s article “A Descriptive Feasibility Study to Evaluate Scheduled Oral Analgesics Dosing at Home for the Management of Postoperative Pain in Preschool Children Following Tonsillectomy.” Pain Medicine 2012; 13: 472–483.
Preventing Opioid-Related Deaths in Children Undergoing Surgery
Article first published online: 13 JUN 2012
Wiley Periodicals, Inc.
Volume 13, Issue 7, pages 982–983, July 2012
How to Cite
SADHASIVAM, S. and MYER III, C. M. (2012), Preventing Opioid-Related Deaths in Children Undergoing Surgery. Pain Medicine, 13: 982–983. doi: 10.1111/j.1526-4637.2012.01419.x
- Issue published online: 13 JUL 2012
- Article first published online: 13 JUN 2012
Tonsillectomy is one of the most commonly done surgical procedures in children. There are many unreported deaths following tonsillectomy in children due to opioids. Genetic variations in liver microenzyme, CYP2D6, had been associated with some of the deaths. Opioids metabolized by CYP2D6 include codeine, tramadol, hydrocodone, and oxycodone. Ultrarapid metabolizers and some extensive metabolizers of CYP2D6 relatively produce more active opioid metabolites resulting in life-threatening adverse effects, especially in young children. Young and obese children with history of sleep apnea are at higher risk of developing serious opioid-related respiratory depression. The adverse outcomes can be avoided and the safety of pain management can be improved by CYP2D6 genetic testing before prescribing these opioids or by using alternative analgesics.