Individual variations in fentanyl pharmacokinetics and pharmacodynamics in preterm infants
Norman, Elisabeth LU ; Kindblom, Jenny M. ; Rane, Anders ; Berg, Ann Cathrine LU ; Schubert, Ulf ; Hallberg, Boubou and Fellman, Vineta LU
(2019)
In Acta Paediatrica, International Journal of Paediatrics
108(8).
p.1441-1446
- Abstract
Aim: Fentanyl pharmacokinetics and pharmacodynamics are lacking in preterm infants. Our aim was to study these and their relation with a new formulation of fentanyl 5 μg/mL for procedural pain. Methods: Preterm infants were given 0.5 (n = 20, median gestational age 26.5; range 23.3–34.1 weeks) and 2 μg/kg (n = 8, 27.4; 25.3–30.7 weeks) fentanyl, respectively, before skin-breaking procedures or tracheal intubation. Blood samples were collected after ten minutes, two, four, eight and 24 hours. Physiologic parameters were monitored and pain scores assessed. Results: The median fentanyl concentrations were 0.18, 0.15, 0.15 and 0.57, 0.37, 0.35 ng/mL at 15–31 minutes, two and four hours and the half-lives were 1.6 to 20.5 or 4.1 to 32.6... (More)
Aim: Fentanyl pharmacokinetics and pharmacodynamics are lacking in preterm infants. Our aim was to study these and their relation with a new formulation of fentanyl 5 μg/mL for procedural pain. Methods: Preterm infants were given 0.5 (n = 20, median gestational age 26.5; range 23.3–34.1 weeks) and 2 μg/kg (n = 8, 27.4; 25.3–30.7 weeks) fentanyl, respectively, before skin-breaking procedures or tracheal intubation. Blood samples were collected after ten minutes, two, four, eight and 24 hours. Physiologic parameters were monitored and pain scores assessed. Results: The median fentanyl concentrations were 0.18, 0.15, 0.15 and 0.57, 0.37, 0.35 ng/mL at 15–31 minutes, two and four hours and the half-lives were 1.6 to 20.5 or 4.1 to 32.6 hours for the low- and high-dose groups, respectively. A significant correlation was seen between weight at study inclusion and half-life (Spearman′s r = −0.9, p < 0.001), volume of distribution (r = −0.8, p < 0.01) and clearance (r = −0.9, p < 0.01) in the low-dose group (n = 9). Pain assessment results were not correlated to pharmacokinetic variables. Fentanyl was well tolerated. Conclusion: The inter-individual variation of fentanyl pharmacokinetics is large in preterm infants, and the dose of 0.5 μg/kg seems not effective for skin-breaking procedures.
(Less)
- author
- Norman, Elisabeth
LU
; Kindblom, Jenny M.
; Rane, Anders
; Berg, Ann Cathrine
LU
; Schubert, Ulf
; Hallberg, Boubou
and Fellman, Vineta
LU
- organization
- publishing date
- 2019-02-05
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Fentanyl, Pain, Pharmacokinetics, Preterm infants
- in
- Acta Paediatrica, International Journal of Paediatrics
- volume
- 108
- issue
- 8
- pages
- 1441 - 1446
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85063109894
- pmid:30721546
- ISSN
- 0803-5253
- DOI
- 10.1111/apa.14744
- language
- English
- LU publication?
- yes
- id
- c5254b41-d71f-4281-88fe-02c7ea4e459a
- date added to LUP
- 2019-03-29 09:57:22
- date last changed
- 2024-04-30 03:22:34
@article{c5254b41-d71f-4281-88fe-02c7ea4e459a,
abstract = {{<p>Aim: Fentanyl pharmacokinetics and pharmacodynamics are lacking in preterm infants. Our aim was to study these and their relation with a new formulation of fentanyl 5 μg/mL for procedural pain. Methods: Preterm infants were given 0.5 (n = 20, median gestational age 26.5; range 23.3–34.1 weeks) and 2 μg/kg (n = 8, 27.4; 25.3–30.7 weeks) fentanyl, respectively, before skin-breaking procedures or tracheal intubation. Blood samples were collected after ten minutes, two, four, eight and 24 hours. Physiologic parameters were monitored and pain scores assessed. Results: The median fentanyl concentrations were 0.18, 0.15, 0.15 and 0.57, 0.37, 0.35 ng/mL at 15–31 minutes, two and four hours and the half-lives were 1.6 to 20.5 or 4.1 to 32.6 hours for the low- and high-dose groups, respectively. A significant correlation was seen between weight at study inclusion and half-life (Spearman′s r = −0.9, p < 0.001), volume of distribution (r = −0.8, p < 0.01) and clearance (r = −0.9, p < 0.01) in the low-dose group (n = 9). Pain assessment results were not correlated to pharmacokinetic variables. Fentanyl was well tolerated. Conclusion: The inter-individual variation of fentanyl pharmacokinetics is large in preterm infants, and the dose of 0.5 μg/kg seems not effective for skin-breaking procedures.</p>}},
author = {{Norman, Elisabeth and Kindblom, Jenny M. and Rane, Anders and Berg, Ann Cathrine and Schubert, Ulf and Hallberg, Boubou and Fellman, Vineta}},
issn = {{0803-5253}},
keywords = {{Fentanyl; Pain; Pharmacokinetics; Preterm infants}},
language = {{eng}},
month = {{02}},
number = {{8}},
pages = {{1441--1446}},
publisher = {{Wiley-Blackwell}},
series = {{Acta Paediatrica, International Journal of Paediatrics}},
title = {{Individual variations in fentanyl pharmacokinetics and pharmacodynamics in preterm infants}},
url = {{http://dx.doi.org/10.1111/apa.14744}},
doi = {{10.1111/apa.14744}},
volume = {{108}},
year = {{2019}},
}