Methadone
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Central sleep apnoea in a child: case report A 10-year-old boy developed severe central sleep apnoea while receiving methadone. The boy was receiving methadone 0.3 mg/kg/day [route not stated] for persistent pain associated with high-risk acute myeloid leukaemia and graft versus host disease. Pulmonary function tests indicated moderately severe restriction and polysomnography identified severe central sleep apnoea. The average length of the central apnoeas was 7 seconds and he spent >95% of his total sleep time in periodic breathing. His mean oxygen saturation was 92% with desaturations as low as 71% [duration of therapy to onset of reaction not stated]. Radiographic imaging and CT scans indicated chronic lung disease. Morning capillary blood bas showed mixed respiratory and metabolic alkalosis. Further investigations identified chemotherapy-related cerebral atrophy and renal insufficiency with impaired methadone clearance; it was thought that this may have contributed to his sleep-related breathing disorder. The boy received non-invasive biventilatory support and slow weaning of his methadone dosage was initiated. Author comment: "To our knowledge, this is the first case report describing severe [central sleep apnoea] and hypoxia in a child with leukaemia on methadone treatment for chronic pain." Amos LB, et al. Severe central sleep apnea in a child with leukemia on chronic methadone therapy. Pediatric Pulmonology 48: 85-87, No. 1, Jan 2013. Available 803083404 from: URL: http://dx.doi.org/10.1002/ppul.22539 - USA
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Reactions 23 Feb 2013 No. 1440
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