Using intravenous (IV) acetaminophen with narcotics provides more effective pain relief to children having tonsillectomies, according to a study presented at the ANESTHESIOLOGY™ 2013 annual meeting. Additionally, the combination therapy saves costs due to reduced use of narcotics after surgery, reduced side effects and slightly quicker hospital discharge than in patients who receive narcotics alone.
The quintessential children's surgery performed on more than 500,000 patients a year was traditionally done for multiple tonsil infections. Today, more than 80 percent of tonsillectomies are done to correct breathing disorders that affect sleep, according to the American Society of Otolaryngology. Sleep apnea is the most common disorder.
In February 2013, the U.S. Food and Drug Administration (FDA) issued a black box warning against the use of codeine (a narcotic) in children undergoing tonsillectomies or adenoidectomies. Certain children have an inherited ability that causes their liver to convert codeine into life-threatening or fatal amounts of morphine or "ultra-rapid metabolizers." Because of the difficulty in determining which children might be ultra-rapid metabolizers of codeine, FDA issued the black box warning for all children.