HealthDay News — Sex influences opioid-related adverse effects in children undergoing tonsillectomy, results of a study published in Pain Medicine indicate.

“Unpredictable inter-individual variability in response to opioids results in inadequate analgesia and opioid-related adverse effects,” wrote Senthilkumar Sadhasivam, MD, MPH, of Cincinnati Children’s Hospital, and colleagues.

To determine the effects of sex on opioid-related adverse effects in children undergoing tonsillectomy, the investigators assessed opioid-related adverse effects in 275 children aged five to 15 years who underwent outpatient tonsillectomy. All study participants received standard perioperative care with a standard intraoperative dose of morphine.

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For girls, but not boys, there was a significant morphine effect for postoperative nausea and vomiting (PONV; P=0.001) and prolonged post-anesthesia recovery unit stay in association with PONV (P=0.010).

There was no significant difference noted in the overall incidence of respiratory depression between boys and girls, but as the total perioperative morphine dose increased to 0.3 mg/kg or more, the incidence of respiratory depression and PONV tended to be higher in white girls than boys (respiratory depression: 52% versus 32%; PONV: 43% versus 4%).


  1. Sadhasivam S et al. Pain Medicine. 2014; doi: 10.1111/pme.12660