Pharmacokinetics of rectal paracetamol after major surgery in children

Paediatr Anaesth. 1995;5(4):237-42. doi: 10.1111/j.1460-9592.1995.tb00291.x.

Abstract

Glycogelatin capsular suppositories containing a paracetamol slurry 40 mg.kg-1 were given PR to 20 children (12 months-17 yrs) after major orthopaedic surgery and plasma concentrations of paracetamol measured for up to 18 h. The mean maximum concentration (Cmax) was 0.115 (SD 0.049) mmol.l-1. Peak concentration occurred (Tmax) at 2.3 (SD 1.2) h. Mean concentration was 0.07 (SD 0.03) mmol.l-1 at six h. Apparent paracetamol clearance was 5.8 ml.min-1.kg-1. The plasma concentration of paracetamol associated with analgesic effectiveness in children is unknown, but antipyretic effects are seen in the range 0.066-0.130 mmol.l-1. Paracetamol suppositories 40 mg.kg-1 given perioperatively achieve effective therapeutic antipyretic plasma concentrations within 1-2 h. The timing is coincident with the recovery phase of short duration paediatric surgery. The coefficient of variance of Cmax was 43%. Some individual patients may not achieve a Cmax which is therapeutic.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetaminophen / administration & dosage*
  • Acetaminophen / pharmacokinetics*
  • Administration, Rectal
  • Analgesics, Non-Narcotic / administration & dosage*
  • Analgesics, Non-Narcotic / pharmacokinetics*
  • Biological Availability
  • Child
  • Female
  • Humans
  • Male
  • Pain, Postoperative / drug therapy*
  • Suppositories
  • Time Factors

Substances

  • Analgesics, Non-Narcotic
  • Suppositories
  • Acetaminophen