Document Detail


Placental transfer and pharmacokinetics of thiopentone in newborn infants.
MedLine Citation:
PMID:  20488867     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Thiopentone, a short-acting barbiturate, has been introduced as premedication for intubation in newborn infants. The objectives of this study were to assess the pharmacokinetics of thiopentone in newborn infants, and to unravel whether placental transfer of the drug should be taken into account if administered to infants exposed to it during delivery. METHODS: Plasma concentrations were assessed with high-pressure liquid chromatography in samples from delivering mothers (n=27) receiving a median dose of 5.5 mg/kg (range 3.8-7.7) thiopentone for Caesarean section in gestational week 37.6 (range 25.7-41.4) and from corresponding umbilical cord blood (n=28). In infants (n=30) born at 35.4 weeks gestation (range 27.9-42.0) undergoing surgery at a median postnatal age of 24.5 h (range 4-521), repeated blood levels were assessed after administering a dose of 3 mg/kg thiopentone on clinical indication before intubation (seven samples per infant from 5 min to 48 h after administration). RESULTS: The umbilical/maternal concentration ratio was 0.7, the mean concentration of thiopentone was 55.7 micromol/l (SD+/-15.3) in mothers and 39.3 micromol/l (SD+/-12.5) in venous cord blood. In newborn infants undergoing surgery, the terminal half-life of thiopentone was 8 h (interquartile range (IQR) 2.5-10.8), and clearance 0.092 l/min per kg/postnatal age in days (IQR 0.02-0.1). CONCLUSIONS: Thiopentone might be used as premedication for short-lasting intubation after birth, for example, for surfactant administration. During the first 4 h after birth the dose needs to be adjusted for maternal dosage as well as for the weight of the infant.
Authors:
Elisabeth Norman; Per Westrin; Vineta Fellman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-20
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  95     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-25     Completed Date:  2010-08-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F277-82     Citation Subset:  AIM; IM    
Affiliation:
Neonatal Intensive Care Unit, University Hospital, Lund, Sweden. elisabeth.norman@med.lu.se
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, General / methods
Anesthesia, Obstetrical / methods
Body Weight
Cesarean Section
Chromatography, High Pressure Liquid / methods
Congenital Abnormalities / surgery
Drug Administration Schedule
Female
Fetal Blood / metabolism
Half-Life
Humans
Hypnotics and Sedatives / administration & dosage,  blood*,  pharmacokinetics
Infant, Newborn / blood*
Male
Maternal-Fetal Exchange
Placenta / metabolism*
Pregnancy
Premedication / methods
Prospective Studies
Thiopental / administration & dosage,  blood*,  pharmacokinetics
Chemical
Reg. No./Substance:
0/Hypnotics and Sedatives; 76-75-5/Thiopental

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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