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Pharmacokinetic model-driven infusion of fentanyl in children.

Publication ,  Journal Article
Ginsberg, B; Howell, S; Glass, PS; Margolis, JO; Ross, AK; Dear, GL; Shafer, SL
Published in: Anesthesiology
December 1996

BACKGROUND: This study determined the accuracy of previously defined adult fentanyl pharmacokinetics in children having surgery; from this population, the pharmacokinetics of fentanyl were characterized in children when administered via a computerized assisted continuous-infusion device. METHODS: Twenty children between the ages of 2.7 and 11 y scheduled to undergo elective noncardiac surgery were studied. After induction, anesthesia was maintained with 60% nitrous oxide in oxygen supplemented with fentanyl (n = 10) or fentanyl plus isoflurane (n = 10). Fentanyl was administered via computerized assisted continuous-infusion to target concentrations determined by clinical requirements. Plasma fentanyl concentrations were measured and used to evaluate the performance of the fentanyl pharmacokinetics and then to determine a new set of pharmacokinetic parameters and the variance in the context-sensitive half-times simulated for these patients. RESULTS: The original adult fentanyl pharmacokinetics resulted in a positive bias (10.4%), indicating that measured concentrations were mostly greater than predicted. A two-compartment model with age and weight as covariates provided the optimal pharmacokinetic parameters. These resulted in a residual performance error of -1.1% and a median absolute performance error of 17.4%. The context-sensitive times determined from this pediatric population were considerably shorter than the context-sensitive times previously published for adults. CONCLUSIONS: The pharmacokinetics of fentanyl administered by computerized assisted continuous-infusion differ between adults and children. The newly derived parameters are probably more suitable to determine infusion schemes of up to 4 h in children between the ages of 2 and 11 y.

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Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

December 1996

Volume

85

Issue

6

Start / End Page

1268 / 1275

Location

United States

Related Subject Headings

  • Models, Biological
  • Humans
  • Fentanyl
  • Computers
  • Child, Preschool
  • Child
  • Anesthetics, Intravenous
  • Anesthesiology
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Ginsberg, B., Howell, S., Glass, P. S., Margolis, J. O., Ross, A. K., Dear, G. L., & Shafer, S. L. (1996). Pharmacokinetic model-driven infusion of fentanyl in children. Anesthesiology, 85(6), 1268–1275. https://doi.org/10.1097/00000542-199612000-00007
Ginsberg, B., S. Howell, P. S. Glass, J. O. Margolis, A. K. Ross, G. L. Dear, and S. L. Shafer. “Pharmacokinetic model-driven infusion of fentanyl in children.Anesthesiology 85, no. 6 (December 1996): 1268–75. https://doi.org/10.1097/00000542-199612000-00007.
Ginsberg B, Howell S, Glass PS, Margolis JO, Ross AK, Dear GL, et al. Pharmacokinetic model-driven infusion of fentanyl in children. Anesthesiology. 1996 Dec;85(6):1268–75.
Ginsberg, B., et al. “Pharmacokinetic model-driven infusion of fentanyl in children.Anesthesiology, vol. 85, no. 6, Dec. 1996, pp. 1268–75. Pubmed, doi:10.1097/00000542-199612000-00007.
Ginsberg B, Howell S, Glass PS, Margolis JO, Ross AK, Dear GL, Shafer SL. Pharmacokinetic model-driven infusion of fentanyl in children. Anesthesiology. 1996 Dec;85(6):1268–1275.

Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

December 1996

Volume

85

Issue

6

Start / End Page

1268 / 1275

Location

United States

Related Subject Headings

  • Models, Biological
  • Humans
  • Fentanyl
  • Computers
  • Child, Preschool
  • Child
  • Anesthetics, Intravenous
  • Anesthesiology
  • 3202 Clinical sciences
  • 1103 Clinical Sciences