Potential Risks of Hemolysis after Short-Term Administration of Analgesics in Children with Glucose-6-Phosphate Dehydrogenase Deficiency

Abstract

To evaluate the risk of hemolysis in children with glucose-6-phosphate dehydrogenase (G6PD) deficiency after short-term administration of analgesics, such as paracetamol, ibuprofen, tramadol, sufentanil, and parecoxib. This was a prospective study of children with G6PD deficiency who were treated with analgesics for 3 days after undergoing surgery. Hemoglobin (Hb) concentration, reticulocyte count, unconjugated bilirubin level, lactate dehydrogenase level, and the presence of Heinz bodies on blood smear microscopy were assessed at baseline and after analgesic treatment. Telephone interviews and clinical reviews were provided during a 7-day study period. The primary outcome was evidence of hemolysis. Statistical analyses were done using the paired Student t test or Wilcoxon signed-rank test as appropriate. Ten male infants (mean age, 4.3 ± 1.3 years) completed the study. The mean decrease in (Hb) concentration was -0.2 g/dL (P, not significant). The mean reticulocyte count increased by 0.1% (95% CI, 0.08%-0.2%; P = .001). However, the change in reticulocyte count was not correlated with the changes in Hb concentration or other laboratory results and was not accompanied by the clinical signs and symptoms of hemolysis. Short-term administration of paracetamol, ibuprofen, tramadol, sufentanil, and parecoxib in therapeutic dosages did not increase the risk of hemolysis in children with G6PD deficiency.