Codeine is often the drug of choice once a surgical procedure is complete as it can go a long way toward easing significant pain. While this method has been used for years in a full range of patient ages, a report out of the University of Western Ontario suggests that using codeine to treat pain following a tonsillectomy could prove fatal in some children.

Science Daily posted a release that examined the findings by Dr. Gideon Koren, who investigated the death of a two year old boy after an operation was performed to remove his tonsils. The procedure proved to be without incident and is a standard practice.

In this particular case, the young boy had a history of snoring and sleep-study-confirmed apnea. After his outpatient procedure, his mother was given codeine syrup and instructed on dosage. The second night after surgery, the child developed a fever and wheezing and was found dead the next morning.

While tests showed the mother had given the right dosage, the body had high levels of morphine. This particular child was found to have the ultra-rapid metabolism genotype, which causes the body to metabolize codeine at a faster rate to produce significantly higher amounts of morphine.

It is estimated that just over one percent of Caucasians carry this gene. For those of African origin, the incidence can be as high as 30 percent. If this is not identified before codeine is prescribed, thus taking the medication could be fatal.

“If the apnea doesn’t go away, codeine will also suppress the child’s breathing,” said Koren. “This demonstrates the need to keep children in hospital under surveillance for at least 24 hours to see if the apnea persists.”