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Anesth Analg 2002;94:266-270
© 2002 International Anesthesia Research Society

PEDIATRIC ANESTHESIA

Age-Stratified Pharmacokinetics of Ketorolac Tromethamine in Pediatric Surgical Patients

Richard M. Dsida, MD*{dagger}, Melissa Wheeler, MD*{dagger}, Patrick K. Birmingham, MD*{dagger}, Zhao Wang, MD{dagger}, Corri L. Heffner, RN*, Charles J. Coté, MD*{dagger}, and Michael J. Avram, PhD{dagger}

*Department of Pediatric Anesthesiology, Children’s Memorial Hospital, Chicago, Illinois; and {dagger}Department of Anesthesiology, Northwestern University Medical School, Chicago, Illinois

Address correspondence and reprint requests to Richard M. Dsida, MD, Department of Pediatric Anesthesiology, Children’s Memorial Hospital, 2300 Children’s Plaza, Chicago, IL 60614. Address e-mail to r-dsida{at}northwestern.edu

Published data suggest that ketorolac pharmacokinetics are different in children than in adults. We sought to better characterize ketorolac pharmacokinetics in children. Thirty-six children, aged 1–16 yr, were stratified into four age groups: 1–3 yr, 4–7 yr, 8–11 yr, and 12–16 yr. Each child received 0.5 mg/kg of ketorolac tromethamine IV after completion of elective surgery. A maximum of 16 venous blood samples (mean, 13 ± 2) were collected at predetermined times up to 10 h after drug administration. Plasma ketorolac concentrations were measured by high-performance liquid chromatography after solid-phase extraction. Individual concentration-versus-time relationships were best fit to a two-compartment pharmacokinetic model by using SAAM II. Body weight-normalized pharmacokinetic variables did not differ among the age groups and were similar to those reported for adults, including a volume of distribution at steady state of 113 ± 33 mL/kg (mean ± SD) and an elimination clearance of 0.57 ± 0.17 mL · min-1 · kg-1. Our study demonstrates that a single dose of ketorolac (0.5 mg/kg) results in plasma concentrations in the adult therapeutic concentration range for 6 h in most children. Our data provide no evidence that children require either larger weight-adjusted doses or shorter dosing intervals than adults to provide similar plasma drug concentrations.

IMPLICATIONS: The literature suggests that ketorolac disposition differs between children and adults. We characterized ketorolac pharmacokinetics in 36 children. Body weight-normalized two-compartment pharmacokinetic variables did not differ among pediatric patients <17 yr old and were similar to adult values.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.