Abstract
To evaluate whether there are age-related differences in the plasma concentration-vs-time course of fentanyl, the authors administered fentanyl to seven infants (3–10 months), seven children (1–9 years) and seven adults (18–41 years). Anaesthesia was induced with thiopentone, nitrous oxide, and pancuronium; following tracheal intubation, fentanyl (approximately 30 µg·kg-1 for infants and children, 20 µg· kg-1 for adults) was administered as a 2-min IV infusion. Anaesthesia was maintained with nitrous oxide, pancuronium, and morphine sulphate as clinically indicated. Plasma samples were obtained for 4 h and fentanyl concentrations determined by radioimmunoassay. Plasma concentrations per µg·kg-1 fentanyl administered were lowest in infants 4–10 and 60–240 min after the start of the 2-min infusion; values for children were lower than those for adults 4,180 and 210 min after the start of the 2-min infusion. These findings are consistent with the authors’ clinical observation that infants tolerate larger doses of fentanyl than do adults.
Résumé
Afin ďévaluer s’il existe des différences reliées à ľâge dans la concentration plasmatique versus temps du fentanyl, les auteurs ont administré du fentanyl à sept nourissons (3–10 mois), sept enfants (1–9 ans) et sept adultes (18–41 ans). Ľinduction de ľanesthésie s’est faite par administration de thiopentone, protoxyde ďazote et pancuronium. Après ľintubation endotrachéal, du fentanyl (approximativement 30 µg·kg-1 pour les nourissons et enfants, 20 µg·kg-1 pour les adultes) a été administré en deux minutes par infusion intraveineuse. Ľanesthésie était maintenue avec le protoxyde ďazote, pancuronium et sulfate de morphine selon la clinique. Les échantillons plasmatiques étaient obtenus pour quatre heures et les concentrations de fentanyl déterminées par radioimmunoessay. Les concentrations plasmatiques par µg·kg-1 de fentanyl administrées étaient plus basses chez les nourissons à 4–10, 60–240 minutes après le début de la perfusion. Les valeurs pour les enfants étaient plus basses que celles de ľadulte 4,180 et 210 minutes après le début de la perfusion. Ces résultats sont consistants avec ľobservation clinique des auteurs à ľeffet que les nourissons tolèrent des doses plus grandes de fentanyl que les adultes.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Cartwright P., Prys-Roberts C., Gill K., Dye A., Stafford M., Gray A. Ventilatory depression related to plasma fentanyl concentrations during and after anesthesia in humans. Anesth Analg 1983; 62: 966–74.
Gelman S., Fowler K.C., Smith L.R. Liver circulation and function during isoflurane and halothane anesthesia. Anesthesiology 1984; 61: 726–30.
Henderson G.L., Frincke J., Leung C.Y., Torten M., Benjamini E. Antibodies to fentanyl. J Pharmacol Exp Theor 1975; 192: 489–96.
Schüttler J., White P.F. Optimization of the radioimmunoassays for measuring fentanyl and alfentanil in human serum. Anesthesiology 1984; 61: 315–20.
Rodbard D. Statistical estimation of the minimal detectable concentration (“sensitivity”) for radioligand assays. Anal Biochem 1978; 90: 1–12.
Zar J.H. Biostatistical Analysis. Englewood Cliffs: Prentice-Hall, 1974; 133-7, 151–8.
Früs-Hansen B. Body composition during growth.In-vivo measurements and biochemical data correlated to differential anatomical growth. Pediatrics 1971; 47: 264–74.
Ehrnebo M., Agurell S., Jalling B., Boreus L.O. Age differences in drug binding by plasma proteins: Studies on human foetuses, neonates and adults. Eur J Clin Pharmacol. 1971; 3: 189–93.
Bower S., Hull C.J. The comparative pharmacokinetics of fentanyl and alfentanil. Br J Anaesth. 1982; 54: 871–7.
Goromaru T., Matsuura H., Yoshimura N. et al. Identification and quantitative determination of fentanyl metabolites in patients by gas chromatography-mass spectrometry. Anesthesiology. 1984; 61: 73–7.
Short C.R., Maines M.D., Westfall B.A. Postnatal development of drug-metabolizing enzyme activity in liver and extra-hepatic tissues of swine. Biol Neonate 1972; 21: 54–68.
Nayak N.C., Ramalingaswami V. Normal structure.In: Chandra R.K., ed. The liver and biliary system in infants and children. Edinburgh: Churchill Livingstone, 1979: 1–17.
Rudolph A.M. Fetal circulation and cardiovascular adjustments after birth.In: Rudolph A.M., Hoffman J.I.E., eds. Pediatrics, 17th Edition. Norwalk, Connecticut: Appleton-Century-Crofts, 1982: 1231–5.
Johnson K.L., Erickson J.P., Holley F.O., Scott J.C. Fentanyl pharmacokinetics in the pediatric population (abstract). Anesthesiology. 1984; 61: A441.
Hudson, R.J., Thomson I.R., Cannon J.E., Friesen R.M., Meatherall R.C. Pharmacokinetics of fentanyl in patients undergoing abdominal aortic surgery. Anesthesiology. 1986; 64: 334–8.
Becker L.D., Paulson B.A., Miller R.D., Severinghaus J.W., Eger El II. Biphasic respiratory depression after fentanyl-droperidol or fentanyl alone used to supplement nitrous oxide anesthesia. Anesthesiology. 1976; 44: 291–6.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Singleton, M.A., Rosen, J.I. & Fisher, D.M. Plasma concentrations of fentanyl in infants, children and adults. Can J Anesth 34, 152–155 (1987). https://doi.org/10.1007/BF03015333
Issue Date:
DOI: https://doi.org/10.1007/BF03015333