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BJA Advance Access published online on May 28, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh178
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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Accepted February 24, 2004

Clinical Investigation

Pharmacokinetics of rectal tramadol in postoperative paediatric patients

J. Zwaveling 1*, S. Bubbers 2, A. H. J. van Meurs 2, R. C. Schoemaker 3, I. Ruijs-Dudok van Heel 3, P. Vermeij 1, J. Burggraaf 3

1 Department of Clinical Pharmacy and Toxicology of the Leiden University Medical Center, Leiden, The Netherlands
2 Juliana's Children Hospital, The Hague, The Netherlands
3 Centre for Human Drug Research, Leiden, The Netherlands

* To whom correspondence should be addressed. E-mail: j.zwaveling{at}lumc.nl.


  Abstract

Background. Postoperative analgesia in children may be improved by using tramadol. The pharmacokinetics of rectal tramadol in young children were therefore investigated.

Methods. The pharmacokinetics of rectal tramadol and its active metabolite were studied in 12 young children (age: 1-6 yr) postoperatively. On the basis of these data, a population model was constructed. Using this model, the pharmacokinetics of different doses of tramadol were calculated.

Results. The pharmacokinetics of rectal tramadol could be adequately described by a one-compartment model. The pharmacokinetic parameters derived from the model indicate that a low variability was present. Elimination half-life was 4.3 (0.2) h (SEM) and the apparent clearance was 16.4 (1.5) litre h-1 (SEM).

Conclusions. The study showed that after rectal administration, tramadol is absorbed at a reasonable rate and with a low inter-individual variability in small children. The data also suggested that a rectal dose of tramadol 1.5-2.0 mg kg-1 is therapeutic.

Br J Anaesth 2004

Keywords: Keywords: analgesia, paediatric; analgesic administration, rectal; analgesics opioid, tramadol; pain


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