Codeine and Oral Surgery Alert
The Food and Drug Administration (FDA) has issued a new warning discouraging the use of codeine after ENT procedures such as tonsil or adenoid removal. This warning was the result of investigations that identified ten otherwise healthy children who died while on Codeine after one of these surgeries. Their age ranged from almost 2 to 9 years of age.
Codeine is a common medication for severe pain used in the first 24-48 hours when OTC medications are expected to be ineffective. The most common complication is nausea when the narcotic is taken on an empty stomach. It’s also worth mentioning that codeine is one of the highest allergenic drugs so parents need to monitor their child after the first dose for the first 1-2 hours for rash and respiratory depression, anaphylaxis or other issues. Although safely used for many other procedures, the respiratory depression properties of narcotics such as codeine which cause a slowdown in breathing is believed to have been compounded by the swelling of the children’s small and inflamed airways due to surgery. This unfortunate combination of factors is worth noting and even considering during other surgical procedures such as frenectomy, performing oral surgery…etc
So, with kids, the minimalist approach is always the best. If pain control could be achieved with over-the-counter alternatives, it might be the way to go. As a caring parent, you will rightfully be concerned about your child’s comfort after a dental procedure. But if your dentist refuses to prescribe something and suggests staying away from narcotics, don’t be disappointed.
Dr. Eftekhari is a proud San Diego native. She received her doctorate from University of the Pacific School of Pharmacy in 2003 as one of their youngest ever graduates. She enjoys the challenges and rewards of interacting with her young patients and their parents as the Director of Pharmacy Services and Clinical Pharmacists at the Children’s Rehabilitation Hospital in Loma Linda. She loves balancing her career and being a mother to her 3 year old active little man, Arman. At home, when she’s not chasing after Arman, she enjoys dancing, cooking, and swimming.