Summary
The effect of hypothermia on the disposition of fentanyl was evaluated in 18 children undergoing corrective cardiac surgery. They received a bolus of fentanyl followed by a continuous infusion which was stopped when cardiopulmonary bypass was established and profound hypothermia was achieved (18 °C–25 °C). Fentanyl plasma concentration remained essentially unchanged during hypothermia (6.45 ng/ml 5 min into hypothermia and 5.26 ng/ml 100–140 min later; p>0.1).
In subsequent experiments, the effect of hypothermia on the pharmacokinetics of fentanyl was studied in 4 piglets serving as their own controls. Both distribution volume (Vz) and total body clearance (CL) were significantly smaller during hypothermia. Our studies indicate that being a drug with a large distribution volume and a high hepatic extraction ratio, both CL and Vz are significantly reduced by hypothermia-induced hypoperfusion. In addition, TBC is influenced by the temperature-dependent hepatic metabolism of fentanyl.
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Dr. Koren is a Career Scientist of the Ontario Ministry of Health
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Koren, G., Barker, C., Goresky, G. et al. The influence of hypothermia on the disposition of fentanyl — Human and animal studies. Eur J Clin Pharmacol 32, 373–376 (1987). https://doi.org/10.1007/BF00543972
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DOI: https://doi.org/10.1007/BF00543972