Codeine After Tonsil Removal Linked to Child Deaths: Study

According to new research, the use of the codeine after tonsil removal has led to a number of children’s deaths, raising concerns over the common practice of sending children home with a prescription for the painkiller following tonsillectomies. 

In a case report published earlier this month in the medical journal Pediatrics, Canadian researchers highlighted three cases in 2010 and 2011 where children died or were faced with life-threatening injuries as a result of codeine use following the removal of their tonsils.

The codeine is often given to children across North America who are receiving tonsillectomies, a common procedure that is used on children who suffer obstructive sleep apnea syndrome, a sleeping disorder that leads to snoring, broken sleep and health problems.

In all of the cases, the children were sent home with a codeine prescription after surgery and spending a day in the hospital. The fatalities detailed in the case study included a five-year-old boy from the southern United States and a four year old boy in Northern Ontario. There was also a three-year-old girl in Canada who was successfully resuscitated.

In both fatalities, the boys shared a gene variant, CYP2D6, that researchers believe may cause the body to process morphine at a faster rate than normal. While the girl who survived did not test positive for the gene, she also appeared to metabolize codeine faster than the typical child.

The resarchers have suggested that doctors consider keeping children hospitalized for longer than 24 hours after tonsil removal, and adjusting doses based on the child’s lean body mass instead of their total body mass. They also note that children could be tested for the gene variant, or doctors could simply rely on other types of painkillers.