The pharmacokinetics of intravenous ketorolac in children aged 2 months to 16 years: A population analysis
Correction(s) for this article
-
Corrigendum
- Volume 28Issue 12Pediatric Anesthesia
- pages: 1159-1159
- First Published online: December 4, 2018
James S. McLay
The Department of Child Health, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
Search for more papers by this authorCorresponding Author
Thomas Engelhardt
The Department of Paediatric Anaesthesia, Royal Aberdeen Children's Hospital, Aberdeen, UK
Correspondence
Dr Thomas Engelhardt, The Department of Paediatric Anaesthesia, Royal Aberdeen Children's Hospital, Aberdeen, UK.
Email: [email protected]
Search for more papers by this authorBaba S. Mohammed
Pharmacology Unit, University of Development Studies, Tamale, Ghana
Search for more papers by this authorGary Cameron
The Department of Child Health, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
Search for more papers by this authorMindy N. Cohen
Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Search for more papers by this authorJeffrey L. Galinkin
Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Search for more papers by this authorUwe Christians
Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Search for more papers by this authorMichael J. Avram
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Search for more papers by this authorThomas K. Henthorn
Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Search for more papers by this authorRichard M. Dsida
Department of Anesthesiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
Search for more papers by this authorAhmed F. Hawwa
School of Pharmacy, Queen's University Belfast, Belfast, UK
Correction added on 28 November 2018 after initial online publication: Dr Ahmed F. Hawwa has been added as the penultimate author.
Search for more papers by this authorBrian J. Anderson
Department of Anaesthesiology, Faculty of Medicine and Health Science, University of Auckland, Auckland, New Zealand
Search for more papers by this authorJames S. McLay
The Department of Child Health, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
Search for more papers by this authorCorresponding Author
Thomas Engelhardt
The Department of Paediatric Anaesthesia, Royal Aberdeen Children's Hospital, Aberdeen, UK
Correspondence
Dr Thomas Engelhardt, The Department of Paediatric Anaesthesia, Royal Aberdeen Children's Hospital, Aberdeen, UK.
Email: [email protected]
Search for more papers by this authorBaba S. Mohammed
Pharmacology Unit, University of Development Studies, Tamale, Ghana
Search for more papers by this authorGary Cameron
The Department of Child Health, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
Search for more papers by this authorMindy N. Cohen
Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Search for more papers by this authorJeffrey L. Galinkin
Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Search for more papers by this authorUwe Christians
Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Search for more papers by this authorMichael J. Avram
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Search for more papers by this authorThomas K. Henthorn
Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Search for more papers by this authorRichard M. Dsida
Department of Anesthesiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
Search for more papers by this authorAhmed F. Hawwa
School of Pharmacy, Queen's University Belfast, Belfast, UK
Correction added on 28 November 2018 after initial online publication: Dr Ahmed F. Hawwa has been added as the penultimate author.
Search for more papers by this authorBrian J. Anderson
Department of Anaesthesiology, Faculty of Medicine and Health Science, University of Auckland, Auckland, New Zealand
Search for more papers by this authorFunding information
This work was funded from institutional resources.
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.
CONFLICT OF INTEREST
Thomas Engelhardt and Brian Anderson sit on the Editorial Board of the journal Pediatric Anesthesia. The authors have no other conflicts of interests to declare.
Supporting Information
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| pan13302-sup-0002-TableS1-2.docxWord document, 12.5 KB |
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