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November 12, 1982

Risks to Children From Tomographic Scan Premedication

JAMA. 1982;248(18):2238-2239. doi:10.1001/jama.1982.03330180012013

To the Editor.—  We would like to comment on the article by Mitchell et al entitled "Risks to Children From Computed Tomographic Scan Premedication" (1982;247:2385).Putting aside all possible or suspected CNS diseases that affect or predispose the patients in this series to respiratory problems or to adverse reactions to premedication, we were not surprised by the elevated risk of life-threatening reactions caused by narcotic drug medication only. It has been shown that CNS depressants and analgesics derived from the morphine alkaloids are more toxic in neonates as a result of the immaturity of the enzymatic system involved in their metabolism.1,2 Way et al3 observed the effect of analgesics given before circumcision on newborn human infants and found that meperidine hydrochloride and morphine sulfate, in doses a third of those ordinarily used in adults on a weight basis, considerably reduced the ventilatory response to carbon dioxide.In the