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How Readily Does Ketorolac Penetrate Cerebrospinal Fluid in Children?
Author(s) -
Kumpulainen Elina,
Kokki Hannu,
Laisalmi Merja,
Heikkinen Marja,
Savolainen Jouko,
Rautio Jarkko,
Lehtonen Marko
Publication year - 2008
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1177/0091270007313389
Subject(s) - ketorolac , cerebrospinal fluid , analgesic , anesthesia , medicine , pharmacology
Ketorolac is a potent nonsteroidal anti‐inflammatory analgesic used in postoperative pain management. Ketorolac elicits its analgesic action by inhibiting the cyclo‐oxygenase enzyme in peripheral tissues and in the spinal cord. Central nervous system penetration of parenteral ketorolac has been evaluated in adults but not in children. In the present study we investigated ketorolac cerebrospinal fluid penetration via spinal anesthesia in 30 healthy children undergoing surgery in the lower part of the body. A single cerebrospinal fluid and blood sample was obtained between 11 minutes and 6 hours after receiving ketorolac 0.5 mgṁkg −1 IV. Ketorolac concentrations were determined by gas chromatography with mass spectrometric detection. Ketorolac was detected from 22 of the 30 cerebrospinal fluid samples, and the concentrations ranged between 0.2 and 7.6 μgṁL −1 (median, 0.6 μgṁL −1 ). The cerebrospinal fluid to unbound plasma concentration‐ratio ranged between 0.01 and 0.69 (median, 0.08). These low concentrations indicate that ketorolac does not readily penetrate cerebrospinal fluid in children.