Abstract |
The pharmacokinetics of morphine have not been previously studied in children following cardiac surgery for tetralogy of Fallot (TOF) or transposition of the great arteries (TGA). Morphine steady-state pharmacokinetics were studied in 21 children undergoing repair of TOF, TGA, or atrio- ventricular septal defects ( AVSD). Children with TOF or TGA had increased right-sided pressures with no differences between the groups. Children with TOF had significantly faster clearance rates of morphine (1.39 +/- 0.37 L/kg/h) than children following the Fontan procedure (0.86 +/- 0.31 L/kg/h, P < 0.01). When stratifying children by their postsurgical needs for inotropic support, those needing epinephrine, dopamine, or dobutamine at more than 10 micrograms/kg/min had significantly slower clearance rates (0.73 +/- 0.3 L/kg/h) when compared to the rest of the patients (1.5 +/- 0.41 L/kg/h, P < 0.05). Because most children needing inotropic support underwent the Fontan procedure, it is conceivable that their cardiovascular status had a major impact on morphine metabolism. These results suggest a 50% reduction in morphine dosage in children requiring inotropic support following cardiac surgery.
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Authors | O Dagan, J Klein, D Bohn, G Barker, G Koren |
Journal | Journal of cardiothoracic and vascular anesthesia
(J Cardiothorac Vasc Anesth)
Vol. 7
Issue 4
Pg. 396-8
(Aug 1993)
ISSN: 1053-0770 [Print] United States |
PMID | 8400092
(Publication Type: Journal Article)
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Chemical References |
- Cardiotonic Agents
- Dobutamine
- Morphine
- Dopamine
- Epinephrine
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Topics |
- Blood Pressure
(physiology)
- Cardiotonic Agents
(pharmacology)
- Child
- Child, Preschool
- Dobutamine
(pharmacology)
- Dopamine
(pharmacology)
- Epinephrine
(pharmacology)
- Female
- Half-Life
- Heart Defects, Congenital
(metabolism, physiopathology, surgery)
- Heart Septal Defects
(metabolism, surgery)
- Humans
- Infant
- Male
- Metabolic Clearance Rate
- Morphine
(administration & dosage, blood, pharmacokinetics)
- Prospective Studies
- Tetralogy of Fallot
(metabolism, surgery)
- Transposition of Great Vessels
(metabolism, surgery)
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