P50 Individual variations in fentanyl pharmacokinetics and pharmacodynamics in preterm infants. Issue 6 (17th May 2019)

• Record Type: Journal Article
• Authors: Kindblom, J; Norman, E; Rane, A; Berg, A-C; Schubert, U; Hallberg, B; Fellman, V
• Is Part Of: Archives of disease in childhood. Volume 104:Issue 6(2019)
• Page Start: e37
• Page End: e38
• Publication Date: 2019-05-17
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-esdppp.88
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Background: Fentanyl pharmacokinetics and pharmacodynamics are lacking in preterm infants. Our aim was to study these and their relation with a new formulation of fentanyl 5 mg/mL for procedural pain. Methods: Preterm infants were given 0.5 (n=20, median gestational age 26.5; range 23.3–34.1 weeks) and 2 mg/kg (n=8, 27.4; 25.3–30.7 weeks) fentanyl, respectively, before skin-breaking procedures or tracheal intubation. Blood samples were collected after ten minutes, two, four, eight and 24 hours. Physiologic parameters were monitored and pain scores assessed. Results: The median fentanyl concentrations were 0.18, 0.15, 0.15 and 0.57, 0.37, 0.35ng/mL at 15–31 minutes, two and four hours and the half-lives were 1.6 to 20.5 or 4.1 to 32.6 hours for the low and high dose groups, respectively. A significant correlation was seen between weight at study inclusion and half-life (Spearman´s r = -0.9, p< 0.001), volume of distribution ( r = -0.8, p < 0.01) and clearance ( r = -0.9, p < 0.01) in the low dose group (n=9). Pain assessment results were not correlated to pharmacokinetic variables. Fentanyl was well tolerated. Conclusion: The inter-individual variation of fentanyl pharmacokinetics is large in preterm infants and the dose of 0.5 mg/kg seems too small for skin-breaking procedures. Disclosure(s): Nothing to disclose