Thiopentone elimination in newborn infants: exploring Michaelis-Menten kinetics

Abstract

Both first-order and mixed-order processes satisfactorily described elimination. First-order elimination adequately described the time-concentration profile in the premature neonate given an overdose. Clearance is immature in the pre-term neonate although there is rapid maturation around 40 weeks PMA, irrespective of post-natal age.

Predictive factors of PACU stay after herniorraphy in infant: a classification and regression tree analysis

“…Regarding the hepatic elimination of this compound and the immaturity of liver enzymatic functions in preterm infants, this might explains the great impact of this parameter on PACU stay. This is supported by a recent study that investigated the pharmacokinetics of a single shot thiopental in newborn and found its elimination decreased in this population as much as 40% of values observed in adults (26). However, no pharmacodynamic study has correlated these results to their hypnotic effects in this population.…”

Resistance of brain glucose metabolism to thiopental‐induced CNS depression in newborn piglets

“…Indeed, newborn piglets needed six‐fold higher concentrations of thiopental than did juvenile pigs to induce a comparable extent of BS (Table 3). Similar age dependent differences in required thiopental doses reported for humans are attributable in part to neonatal pharmacokinetic characteristics, which included elevated clearance (Larsson et al, 2011; Stanski and Maitre, 1990).…”