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The Disposition of Alfentanil in Neonates with Respiratory Distress
Author(s) -
Wiest Donald B.,
Ohning Bryan L.,
Garner Sandra S.
Publication year - 1991
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1991.tb04293.x
Subject(s) - alfentanil , pharmacokinetics , respiratory distress , volume of distribution , anesthesia , medicine , pharmacology , propofol
The disposition of continuous infusion alfentanil was evaluated in 13 mechanically ventilated neonates (gestational age 37.6 ± 2.4 wks) with hyaline membrane disease (n=7) or persistent pulmonary hypertension of the newborn (n=6). Alfentanil was administered as a loading dose 8 μg/kg, followed by a variable‐rate continuous infusion (maximum 10 μg/kg/hr; minimum 2.5 μg/kg/hr) for 27 hours. Serial plasma samples were obtained for pharmacokinetic analysis. Noncompartmental pharmacokinetic analysis of the data revealed the following estimates (mean ± SD): total‐body clearance 3.24 ± 2.23 ml/kg/minute, volume of distribution 0.54 ± 0.21 L/kg, and elimination half‐life 4.14 ± 2.58 hours. A significant effect of alfentanil plasma concentration on total‐body clearance was found (r=‐0.75; p=0.02), suggesting nonlinear pharmacokinetics. No correlation was seen between total‐body clearance and alfentanil dose (r=‐0.37; p=0.32). The results suggest that a larger dose‐proportionality study is required to determine the linearity or nonlinearity of alfentanil pharmacokinetics in neonates.