| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Canadian Journal of Anesthesia, Vol 42, 982-986, Copyright © 1995 by Canadian Anesthesiologists' Society
ARTICLES |
CJ Montgomery, JP McCormack, CC Reichert and CP Marsland
Department of Anaesthesia, University of British Columbia, Vancouver, Canada.
Although the recommended dose of rectal acetaminophen (25-30 mg.kg-1) is twice that for oral administration (10-15 mg.kg-1), the literature justifies the use of a higher dose when acetaminophen is administered via the rectal route. We measured venous plasma acetaminophen concentrations resulting from 45 mg.kg-1 of rectal acetaminophen in ten ASA 1, 15 kg paediatric patients undergoing minor surgery with a standardized anaesthetic. After induction of anaesthesia, a single 650 mg suppository (Abenol, SmithKline Beecham Pharma Inc.) was administered rectally. Plasma was sampled at t = 0, 15, 30, 45, 60, 90, 120, 180, 240 min in the first five patients and at t = 0, 30, 60, 90, 120, 180, 240, 300, 420 min in the subsequent five. Acetaminophen plasma concentrations were determined using a TDxFLx fluorescence polarization immunoassay (Abbott Laboratories, Toronto, Ontario). The maximum plasma concentration was 88 +/- 39 mumol.L-1 (13 +/- 6 micrograms.ml-1) and the time of peak plasma concentration was 198 +/- 70 min (mean +/- SD). At 420 min, the mean plasma concentration was 46 +/- 18 mumol.L-1 (7.0 +/- 0.9 micrograms.ml-1). No plasma concentrations associated with toxicity (> 800 mumol.L-1) were identified. A 45 mg.kg-1 rectal dose of acetaminophen resulted in peak plasma concentrations comparable with those resulting from 10-15 mg.kg-1 of oral acetaminophen at three hours after suppository insertion. It is concluded that the delayed and erratic absorption of acetaminophen after rectal administration leads to unpredictable plasma concentrations. Rectal acetaminophen will not be consistently effective for providing rapid onset of analgesia in children.
This article has been cited by other articles:
 |
|
 |
|
  F. Capici, P. M. Ingelmo, A. Davidson, C. A. Sacchi, B. Milan, L. R. Sperti, L. Lorini, and R. Fumagalli Randomized controlled trial of duration of analgesia following intravenous or rectal acetaminophen after adenotonsillectomy in children Br. J. Anaesth., February 1, 2008; 100(2): 251 - 255. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P.-A. Lonnqvist and N. S. Morton Postoperative analgesia in infants and children Br. J. Anaesth., July 1, 2005; 95(1): 59 - 68. [Full Text] [PDF]
|
|
|
|
 |
|
 M. L Varela and M. A. Howland Single High-Dose Rectal Acetaminophen in Children Ann. Pharmacother., November 1, 2004; 38(11): 1935 - 1941. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Scolnik, E. Kozer, S. Jacobson, S. Diamond, and N. L. Young Comparison of Oral Versus Normal and High-Dose Rectal Acetaminophen in the Treatment of Febrile Children Pediatrics, September 1, 2002; 110(3): 553 - 556. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Stocker and J. E. Montgomery Serum paracetamol concentrations in adult volunteers following rectal administration Br. J. Anaesth., October 1, 2001; 87(4): 638 - 640. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. C. Finkel, I. T. Cohen, R. S. Hannallah, K. M. Patel, M. S. Kim, K. A. Hummer, S. S. Choi, M. Pena, S. B. Schreiber, and G. Zalzal The Effect of Intranasal Fentanyl on the Emergence Characteristics After Sevoflurane Anesthesia in Children Undergoing Surgery for Bilateral Myringotomy Tube Placement Anesth. Analg., May 1, 2001; 92(5): 1164 - 1168. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. H. Bremerich, G. Neidhart, K. Heimann, P. Kessler, and M. Behne Prophylactically-Administered Rectal Acetaminophen Does Not Reduce Postoperative Opioid Requirements in Infants and Small Children Undergoing Elective Cleft Palate Repair Anesth. Analg., April 1, 2001; 92(4): 907 - 912. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. W. Hahn, S. W. Henneberg, R. J. Holm-Knudsen, K. Eriksen, S. N. Rasmussen, and M. Rasmussen Pharmacokinetics of rectal paracetamol after repeated dosing in children Br. J. Anaesth., October 1, 2000; 85(4): 512 - 519. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. H. Beck, M. R. Schenk, K. Hagemann, U. R. Doepfmer, and W. J. Kox The Pharmacokinetics and Analgesic Efficacy of Larger Dose Rectal Acetaminophen (40 mg/kg) in Adults: A Double-Blinded, Randomized Study Anesth. Analg., February 1, 2000; 90(2): 431 - 431. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
