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可待因与曲马多在儿科患者围手术期的应用

The Perioperative Use of Codeine and Tramadol in Pediatric Population.

作者信息

Maisat Wiriya, Yuki Koichi

机构信息

Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, USA.

出版信息

Transl Perioper Pain Med. 2025;12(1):694-696. doi: 10.31480/2330-4871/198. Epub 2025 Feb 10.

DOI:10.31480/2330-4871/198
PMID:40256012
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12007907/
Abstract

Codeine and tramadol are two commonly used opioids for pediatric pain. However, death and severe respiratory distress cases following codeine administration illustrated there would be a significant heterogenous response to these opioids depending on CYP2D6 phenotypes, leading to FDA warning against pediatric use. Here we will comment on the current status of pediatric pain management in the context of codeine and tramadol.

摘要

可待因和曲马多是两种常用于治疗儿童疼痛的阿片类药物。然而,服用可待因后出现的死亡和严重呼吸窘迫病例表明,根据CYP2D6基因表型,这些阿片类药物会产生显著的个体差异反应,导致美国食品药品监督管理局(FDA)发出禁止儿童使用的警告。在此,我们将结合可待因和曲马多来评述儿童疼痛管理的现状。

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The Perioperative Use of Codeine and Tramadol in Pediatric Population.可待因与曲马多在儿科患者围手术期的应用
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本文引用的文献

1
Tramadol Use in Pediatric Surgery: Trends After the Food and Drug Administration Black-Box Warning.曲马多在小儿外科学中的应用:食品和药物管理局黑框警告后的趋势。
J Surg Res. 2022 Dec;280:10-18. doi: 10.1016/j.jss.2022.07.008. Epub 2022 Aug 6.
2
A hybrid implementation-effectiveness randomized trial of CYP2D6-guided postoperative pain management.CYP2D6 指导下的术后疼痛管理的混合实施效果随机试验。
Genet Med. 2021 Apr;23(4):621-628. doi: 10.1038/s41436-020-01050-4. Epub 2021 Jan 8.
3
Multi-site investigation of strategies for the clinical implementation of CYP2D6 genotyping to guide drug prescribing.多中心研究 CYP2D6 基因分型指导药物处方的临床实施策略。
Genet Med. 2019 Oct;21(10):2255-2263. doi: 10.1038/s41436-019-0484-3. Epub 2019 Mar 21.
4
The Case for Pharmacogenetics-Guided Prescribing of Codeine in Children.儿童可待因药物基因组学指导处方的依据
Clin Pharmacol Ther. 2019 Jun;105(6):1300-1302. doi: 10.1002/cpt.1260. Epub 2018 Nov 22.
5
Effect of FDA Investigation on Opioid Prescribing to Children After Tonsillectomy/Adenoidectomy.美国食品药品监督管理局(FDA)调查对扁桃体切除术/腺样体切除术后儿童阿片类药物处方的影响。
Pediatrics. 2017 Dec;140(6). doi: 10.1542/peds.2017-1765. Epub 2017 Nov 16.
6
Clinical Pharmacogenetics Implementation Consortium guidelines for cytochrome P450 2D6 genotype and codeine therapy: 2014 update.临床药物遗传学实施联盟 CYP2D6 基因型和可待因治疗指南:2014 年更新。
Clin Pharmacol Ther. 2014 Apr;95(4):376-82. doi: 10.1038/clpt.2013.254. Epub 2014 Jan 23.
7
More codeine fatalities after tonsillectomy in North American children.北美儿童扁桃体切除术后更多可待因致命病例。
Pediatrics. 2012 May;129(5):e1343-7. doi: 10.1542/peds.2011-2538. Epub 2012 Apr 9.
8
Has the time come to phase out codeine?是时候逐步淘汰可待因了吗?
CMAJ. 2010 Nov 23;182(17):1825. doi: 10.1503/cmaj.101411. Epub 2010 Oct 4.
9
Codeine, ultrarapid-metabolism genotype, and postoperative death.可待因、超快代谢基因型与术后死亡
N Engl J Med. 2009 Aug 20;361(8):827-8. doi: 10.1056/NEJMc0904266.
10
Drug dosing error with drops: severe clinical course of codeine intoxication in twins.滴剂用药错误:双胞胎中可待因中毒的严重临床过程。
Eur J Pediatr. 2009 Jul;168(7):819-24. doi: 10.1007/s00431-008-0842-7. Epub 2008 Oct 21.