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Bioavailability of rectal acetaminophen in children following anorectal surgery

Reza Shojaeian1, Anahita Alizadeh Ghamsari1, Ahmad Mohammadipour2

  • 1Mashhad University of Medical Sciences, Iran.

Journal of Pediatric Surgery
|August 1, 2020
PubMed

Insights

Rectal acetaminophen bioavailability may change in children after anorectal surgery. Caution is advised with rectal acetaminophen in infants with a history of anorectal operations due to potential toxic levels.

Area of Science:

  • Pediatric Surgery
  • Pharmacokinetics
  • Anorectal Surgery

Background:

  • Rectal acetaminophen is commonly used in pediatrics.
  • Anorectal surgery can alter drug pharmacokinetics.
  • The impact on rectal acetaminophen bioavailability is not well understood.

Purpose of the Study:

  • To investigate acetaminophen plasma concentrations in children post-anorectal surgery.
  • To determine the absorption, safety, and efficacy of rectal acetaminophen in this population.

Main Methods:

  • Prospective comparative study involving 60 children.
  • Groups included Hirschsprung's disease (HD), imperforate anus (IA) repair, and inguinal herniotomy.
  • Blood samples were collected 4, 8, and 12 hours after a single rectal dose (40 mg/kg).

Main Results:

  • Children with HD showed significantly higher acetaminophen levels than the herniotomy group (P < 0.05).
  • IA group had higher concentrations than the herniotomy group, but not statistically significant.
  • Acetaminophen levels in IA and HD groups exceeded the therapeutic range at 4 hours.

Conclusions:

  • Rectal acetaminophen bioavailability may be altered following major anorectal surgery in children.
  • Administer rectal acetaminophen with caution in children with a history of anorectal operations.
  • Repeated doses could lead to toxic drug concentrations in these patients.
Abstract

Keywords:
AcetaminophenAnorectal malformationHirschsprung's diseasePediatricsRectal

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