Pediatric anesthesia & critical care
Multicenter Population Pharmacokinetics of Fentanyl in Neonatal Surgical Patients Using Dried Blood Spot Specimen Collection Demonstrates Maturation of Elimination Clearance
Authors' conclusion
A supra-allometric effect on clearance was determined during covariate analyses (exponential scaling factor for body weight >0.75), as has been described in population PK models that account for maturation of intrinsic clearance (here, predominantly hepatic microsomal activity) in addition to scaling for weight, both of which impact clearance in this age group.
Study context
- Population
- Term and preterm neonates up to 42 weeks postmenstrual age receiving fentanyl boluses and continuous infusions
- Outcome
- Fentanyl clearance
Methodological detailsdried blood spot sampling, population pharmacokinetic (PK) analysis, stepwise covariate analysis, Covariates assessed stepwise: body weight, postmenstrual age (PMA), birth status (preterm or term), congenital cardiac disease
- Dried blood spot sampling
- Population PK analysis
- Stepwise covariate analysis
- Covariates assessed stepwise: body weight, PMA, birth status (preterm or term), congenital cardiac disease
Main finding
As reported in the abstract
- Clearance estimated greater than adult fentanyl clearance and varied with weight
- No significant relationship between age (continuous, or term vs preterm [<37 weeks PMA at birth]) and clearance
- Supra-allometric effect of weight on clearance (exponential scaling factor for body weight >0.75)
Observational data: associations, not effects.
Original publication
Multicenter Population Pharmacokinetics of Fentanyl in Neonatal Surgical Patients Using Dried Blood Spot Specimen Collection Demonstrates Maturation of Elimination Clearance. Anesth Analg. Published 12 January 2024. doi:10.
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