Children’s Deaths Linked With Postsurgical Codeine

Mu Opioids and Their Receptors: Evolution of a Concept

“…Indeed, ultrarapid metabolizers may even overdose or encounter respiratory depression. This is well described in several studies looking at the use of codeine after surgery in children (Kelly et al, 2012;Voelker, 2012;Kuehn, 2013). It is presumed that similar situations exist for oxycodone and hydrocodone.…”

Postoperative pain, pain management, and recovery at home after pediatric tonsil surgery

“…In our clinical practice, clonidine is an effective analgesic as part of the management of postoperative pain and has fewer side effects than opioids. The most serious side effect of opioids is respiratory depression, and fatal outcome has been described when used after tonsil surgery for pain relief [20].…”

Clinician opioid prescribing practices and patient utilization of prescribed opioids in pediatrics

“…In particular, children with sleep-disordered breathing may have increased sensitivity to opioids leading to significant respiratory depression, anoxic brain injury, and even death. 20 While some of this risk has been attributed to potential genetic factors, 21,22 suggesting that genetic screening might help identify those at risk, the practical approach of generally reducing opioid dosing and using alternative medications to opioids has been shown to reduce the incidence of respiratory events requiring intervention. 23 While our study did not address risk factors for opioid addiction, recognized risk factors do exist, including past alcohol, cocaine, and drug abuse, prior drinking under the influence (DUI) conviction, 24 major depression, 25 and psychotropic medication use.…”