Age-stratified pharmacokinetics of ketorolac tromethamine in pediatric surgical patients

Richard Dsida*, Melissa Wheeler, Patrick K Birmingham, Zhao Wang, Corri L. Heffner, Charles J. Coté, Michael J Avram

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

57 Scopus citations


Published data suggest that ketorolac pharmacokinetics are different in children than in adults. We sought to better characterize ketorolac pharmacokinetics in children. Thirty-six children, aged 1-16 yr, were stratified into four age groups: 1-3 yr, 4-7 yr, 8-11 yr, and 12-16 yr. Each child received 0.5 mg/kg of ketorolac tromethamine IV after completion of elective surgery. A maximum of 16 venous blood samples (mean, 13 ± 2) were collected at predetermined times up to 10 h after drug administration. Plasma ketorolac concentrations were measured by high-performance liquid chromatography after solid-phase extraction. Individual concentration-versus-time relationships were best fit to a two-compartment pharmacokinetic model by using SAAM II. Body weight-normalized pharmacokinetic variables did not differ among the age groups and were similar to those reported for adults, including a volume of distribution at steady state of 113 ± 33 mL/kg (mean ± SD) and an elimination clearance of 0.57 ± 0.17 mL · min-1 · kg-1. Our study demonstrates that a single dose of ketorolac (0.5 mg/kg) results in plasma concentrations in the adult therapeutic concentration range for 6 h in most children. Our data provide no evidence that children require either larger weightadjusted doses or shorter dosing intervals than adults to provide similar plasma drug concentrations.

Original languageEnglish (US)
Pages (from-to)266-270
Number of pages5
JournalAnesthesia and analgesia
Issue number2
StatePublished - 2002

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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