AIRR - ANZCA Institutional Research Repository
Skip navigation
Please use this identifier to cite or link to this item: https://hdl.handle.net/11055/467
Full metadata record
DC FieldValueLanguage
dc.contributor.authorTan, Lena-
dc.contributor.authorTaylor, E-
dc.contributor.authorHannam, Jacqueline A-
dc.contributor.authorSalkeld, Lesley-
dc.contributor.authorSalman, Sam-
dc.contributor.authorAnderson, BJ-
dc.date2016-
dc.date.accessioned2018-04-09T04:45:54Z-
dc.date.available2018-04-09T04:45:54Z-
dc.date.issued2016-12-
dc.identifier.citationPaediatric anaesthesia 2016-12; 26(12): 1126-1135-
dc.identifier.urihttp://hdl.handle.net/11055/467-
dc.description.abstractFew pharmacokinetic (PK) and pharmacodynamic (PD) data exist for COX-2 selective inhibitors in children. We wished to characterize the PKPD of parecoxib and its active metabolite, valdecoxib, in this population. Children (n = 59) were randomized to parecoxib 0.25 mg·kg-1, 1 mg·kg-1, and 2 mg·kg-1during tonsillectomy ± adenoidectomy. Samples (4-6 per child) were obtained from indwelling cannula over 6 h. A second group of inpatient children (n = 15) given 1 mg·kg-1contributed PK data from 6 to 24 h. Pain scores and rescue medication for the first group were recorded postoperatively for up to 24 h. PK data were pooled with those (10 samples/24 h) from a published study of children (n = 38) who underwent surgery. A three-compartment parent and one-compartment metabolite model with first-order elimination was used to describe data using nonlinear mixed effects models. An EMAXmodel described the relationship between dose and rescue morphine equivalents during recovery. Parecoxib PK parameter estimates were CLPARECOXIB19.1 L·h-1·70 kg-1, V1PARECOXIB4.2 L·70 kg-1, Q2PARECOXIB6.29 L·h-1·70 kg-1, V2PARECOXIB130 L·70 kg-1, Q3PARECOXIB6.02 L·h-1·70 kg-1, and V3PARECOXIB2.03 L·70 kg-1. We assumed all parecoxib was metabolized to valdecoxib with CLVALDECOXIB9.53 L·h-1·70 kg-1and VVALDECOXIB51 L·70 kg-1. There was no maturation of clearance over the age span studied. There were no differences in pain scores between groups on waking, discharge, 12 h, or 24 h. There were no differences in analgesia consumption over 24 h between groups for tramadol, fentanyl, and morphine rescue use. Fentanyl and morphine consumption, expressed as morphine equivalents (0.13 mg·kg-1) in the 0.25 mg·kg-1group, was greater than that observed in the 1 or 2 mg·kg-1groups (0.095 mg·kg-1) in PACU. Parecoxib 0.9 mg·kg-1in a 2-year-old, 0.75 mg·kg-1in a 7-year-old, and 0.65 mg·kg-1in a 12-year-old child achieves dose equivalence of 40 mg in a standard 70 kg person. Clearance maturation may occur in infants younger than the current cohort. Parecoxib doses above 1 mg·kg-1add no additional analgesia.-
dc.language.isoeng-
dc.subject.meshAdolescent-
dc.subject.meshAnalgesia-
dc.subject.meshChild-
dc.subject.meshChild, Preschool-
dc.subject.meshCyclooxygenase 2 Inhibitors-
dc.subject.meshIsoxazoles-
dc.subject.meshPain, Postoperative-
dc.subject.meshTreatment Outcome-
dc.subject.meshAdenoidectomy-
dc.subject.meshTonsillectomy-
dc.titlePharmacokinetics and analgesic effectiveness of intravenous parecoxib for tonsillectomy ± adenoidectomy.-
dc.typeJournal Article-
dc.typeRandomized Controlled Trial-
dc.identifier.journaltitlePaediatric anaesthesia-
dc.identifier.doi10.1111/pan.13009-
dc.description.pubmedurihttps://www.ncbi.nlm.nih.gov/pubmed/27779354-
dc.identifier.pubmedid27779354-
dc.ispartof.anzcaresearchfoundationYes-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.cerifentitytypePublications-
item.cerifentitytypePublications-
item.openairetypeJournal Article-
item.openairetypeRandomized Controlled Trial-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
Appears in Collections:Scholarly and Clinical
Show simple item record

Page view(s)

46
checked on Mar 28, 2024

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.