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- Title
The pharmacokinetics of intravenous ketorolac in children aged 2 months to 16 years: A population analysis.
- Authors
McLay, James S.; Engelhardt, Thomas; Mohammed, Baba S.; Cameron, Gary; Cohen, Mindy N.; Galinkin, Jeffrey L.; Christians, Uwe; Avram, Michael J.; Henthorn, Thomas K.; Dsida, Richard M.; Anderson, Brian J.
- Abstract
Summary: Background: Intravenous ketorolac is commonly administered to children for the control of postoperative pain. An effect site EC50 for analgesia of 0.37 mg.L−1 is described in adults. Aims: The aim of this study was to review age‐ and weight‐related effects on ketorolac pharmacokinetic parameters in children and current dosing schedules. Methods: Pooled intravenous ketorolac (0.5 mg.kg−1) concentration‐time data in children aged 2 months to 16 years were analyzed using nonlinear mixed‐effects models. Allometry was used to scale to a 70 kg person. Results: There were 64 children aged 2 months to 16 years (641 plasma concentrations) available for analysis. A two‐compartment mammillary model was used to describe pharmacokinetics. Clearance was 2.53 (CV 45.9%) L.h−1.70 kg−1 and intercompartment clearance was 4.43 (CV 95.6%) L.h−1.70 kg−1. Both central (V1) and peripheral (V2) volumes of distribution decreased with age over the first few years of postnatal life to reach V1 6.89 (CV 30.3%) L.70 kg−1 and V2 5.53 (CV 47.6%) L.70 kg−1. Conclusion: Clearance, expressed as L.h−1.kg−1, decreased with age from infancy. A dosing regimen of 0.5 mg.kg−1 every 6 hours maintains a trough concentration larger than 0.37 mg.L−1 in children 9 months to 16 years of age. This dosing regimen is consistent with current recommendations.
- Subjects
POSTOPERATIVE pain prevention; PHARMACOKINETICS; KETOROLAC; ANALGESIA; CHILDREN'S health
- Publication
Pediatric Anesthesia, 2018, Vol 28, Issue 2, p80
- ISSN
1155-5645
- Publication type
Article
- DOI
10.1111/pan.13302