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01.08.2012 | Original Research Article

Propofol Clearance in Morbidly Obese Children and Adolescents

Influence of Age and Body Size

verfasst von: Jeroen Diepstraten, Vidya Chidambaran, Senthilkumar Sadhasivam, Hope R. Esslinger, Shareen L. Cox, Thomas H. Inge, Catherijne A. J. Knibbe, Professor Alexander A. Vinks

Erschienen in: Clinical Pharmacokinetics | Ausgabe 8/2012

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Abstract

Background and Objective

Given the alarming increase in obesity among children undergoing surgery, the main aim of this study was to characterize propofol clearance in a cohort of morbidly obese children and adolescents in relation to their age and body weight characteristics.

Methods

A prospective pharmacokinetic study in morbidly obese children and adolescents undergoing elective surgery was conducted. Serial blood samples were collected and nonlinear mixed-effects modelling using NONMEM® was performed to characterize propofol pharmacokinetics with subsequent evaluation of age and body size descriptors.

Results

Twenty obese and morbidly obese children and adolescents with a mean age of 16 years (range 9–18 years), a mean total body weight (TBW) of 125 kg (range 70–184 kg) and a mean body mass index of 46kg/m² (range 31–63 kg/m²) were available for pharmacokinetic modelling using a two-compartment pharmacokinetic model (n = 294 propofol concentration measurements). Compared with lean body weight and ideal body weight, TBW proved to be the most predictive covariate for clearance [CL (L/min)= 1.70 × (TBW/70)^0.8]. Central volume of distribution, peripheral volume and intercompartmental clearance were 45.2 L, 128 L and 1.75 L/min, respectively, with no predictive covariates identifiable.

Conclusion

In the population pharmacokinetic model for propofol in morbidly obese children and adolescents, TBW proved to be the most significant determinant for clearance. As a result, it is anticipated that dosage of propofol for maintenance of anaesthesia in morbidly obese children and adolescents should be based on TBW using an allometric function.

Trial registration number (clinicaltrials.gov)

NCT00948597

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Titel: Propofol Clearance in Morbidly Obese Children and Adolescents
Influence of Age and Body Size
verfasst von: Jeroen Diepstraten
Vidya Chidambaran
Senthilkumar Sadhasivam
Hope R. Esslinger
Shareen L. Cox
Thomas H. Inge
Catherijne A. J. Knibbe
Professor Alexander A. Vinks
Publikationsdatum: 01.08.2012
Verlag: Springer International Publishing
Erschienen in: Clinical Pharmacokinetics / Ausgabe 8/2012
Print ISSN: 0312-5963
Elektronische ISSN: 1179-1926
DOI: https://doi.org/10.1007/BF03261930

Springer Medizin

Abstract

Background and Objective

Methods

Results

Conclusion

Trial registration number (clinicaltrials.gov)

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