Post-tonsillectomy codeine could be fatal

LONDON, Ontario, Aug. 20 (UPI) -- A doctor in Canada warns the use of codeine to treat pain following a tonsillectomy could prove fatal for some children.

Dr. Gideon Koren of the University of Western Ontario investigated the death of a 2-year-old boy following a tonsillectomy. Koren said enlarged tonsils are usually treated with antibiotics, but tonsillectomies are performed in the case of sleep apnea, in which the child stops breathing while asleep.

The toddler, who had a history of snoring and sleep-study-confirmed sleep apnea, had the operation at an outpatient clinic and was taken home. The mother was given syrup of codeine and instructed how to administer it to her child for pain relief -- and on the second night after surgery, the child developed a fever and wheezing, and was found dead the next morning.

"The child was found to have the ultra-rapid metabolism genotype which causes the body to metabolize codeine at a faster rate, producing significantly higher amounts of morphine," Koren said in a statement.

If the apnea doesn't go away, codeine will also suppress the child's breathing, Koren said.

"This demonstrates the need to keep children in hospital under surveillance for at least 24 hours to see if the apnea persists," Koren said.