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Alfentanil pharmacokinetics in preterm infants
N Marlow1, A M Weindling, A Van Peer
1Department of Child Health, Liverpool Maternity Hospital.
Archives of Disease in Childhood
|April 1, 1990
Summary
This study examined alfentanil pharmacokinetics in preterm infants. Individual responses varied, necessitating careful dosage adjustments for safe and effective use in neonates.
Area of Science:
- Neonatal pharmacology
- Clinical pharmacokinetics
- Pediatric intensive care
Background:
- Alfentanil is used for analgesia and sedation in neonates.
- Limited pharmacokinetic data exists for preterm infants, especially those on muscle relaxants.
Purpose of the Study:
- To characterize alfentanil pharmacokinetics in ventilated preterm infants.
- To determine appropriate infusion dosing for alfentanil in this population.
Main Methods:
- Pharmacokinetic analysis of alfentanil serum concentrations after single doses and infusions.
- Study included 22 ventilated preterm infants receiving muscle relaxants.
- Dosing regimens were adjusted based on individual infant data.
Main Results:
- Significant inter-individual variability in alfentanil clearance and elimination half-life was observed.
- Median serum concentration after a 20 mcg/kg dose was 66 ng/ml.
- An infusion regimen (20 mcg/kg over 30 min, then 5 mcg/kg/hr) achieved stable concentrations without accumulation.
Conclusions:
- Alfentanil handling varies widely in preterm neonates.
- Careful dose titration is crucial for alfentanil therapy in this vulnerable population.
- The studied infusion regimen appears safe and effective for maintaining therapeutic alfentanil levels.