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Pharmacokinetics of i.v. and rectal pethidine in children undergoing ophthalmic surgery
K Hamunen1, E L Maunuksela, T Seppälä
1Department of Ophthalmology, University of Helsinki, Finland.
Insights
This study examined intravenous (IV) and rectal pethidine pharmacokinetics in children. Rectal pethidine showed highly variable bioavailability, making it unsuitable for managing acute pain.
Area of Science:
- Pharmacology
- Pediatric Anesthesiology
Background:
- Pethidine (also known as meperidine) is an opioid analgesic.
- Understanding its pharmacokinetic profile in pediatric populations is crucial for effective pain management.
Purpose of the Study:
- To investigate the pharmacokinetics of intravenous (IV) and rectal pethidine administration.
- To determine the systemic bioavailability of rectal pethidine in children.
Main Methods:
- Pharmacokinetic study involving 20 children aged 4-8 years undergoing ophthalmic surgery.
- Administration of pethidine via IV and rectal routes.
- Measurement of plasma pethidine concentrations over time.
Main Results:
- After IV administration, pethidine exhibited a clearance of 10.4 mL/kg/min, volume of distribution of 2.8 L/kg, and elimination half-life of 3.0 hours.
- Rectal pethidine administration resulted in highly variable plasma concentrations with late peak concentrations (147 min).
- Mean systemic bioavailability of rectal pethidine was approximately 55%.
Conclusions:
- The pharmacokinetic profile of IV pethidine in children is characterized by specific clearance, volume of distribution, and half-life values.
- Rectal pethidine exhibits significant inter-individual variability in absorption and bioavailability.
- Due to its unpredictable absorption, the rectal route is not recommended for managing acute pain in pediatric patients.
Abstract:
We have studied the pharmacokinetics of i.v. and rectal pethidine in 20 children age 4-8 yr undergoing ophthalmic surgery. After i.v. administration, the clearance of pethidine was mean 10.4 (SD 1.7) ml kg-1 min-1, volume of distribution at steady state 2.8 (0.6) litre kg-1 and elimination half-life 3.0 (0.5) h. After rectal administration, plasma pethidine concentrations varied greatly and peak concentrations appeared late, at 147 (44) min. The mean systemic bioavailability after rectal administration was approximately 55%. Because the bioavailability of rectal pethidine varies greatly, this route is not encouraged in the management of acute pain.