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. Author manuscript; available in PMC: 2019 Feb 1.
Published in final edited form as: Clin Pharmacokinet. 2018 Feb;57(2):125–149. doi: 10.1007/s40262-017-0569-6

Table 4.

Pharmacokinetic information on alfentanil in children [13, 131, 132, 134–137, 142–144, 148, 149, 188, 190, 191].

n Age Weight
(kg)		 Dose
(µg/kg)		 Route CL
(mL/min/kg)		 t1/2
(min)		 V
(L/kg)		 Comp No of samples Lab method Remarks Ref.
5 6.2 ± 4.2 months 7.4 ± 2.6 50 IV, 30 sec 8.39 ± 0.80a) 76.2 ± 8.2a) 0.552 ± 0.105a) 2 14/
6h		 RIA
[188]		 age < 1 year; AUC 6.183 ± 0.602a) min*mg/L [13]
8 5.4 ± 4.4 years 20.2 ± 11.3 50 IV, 30 sec 7.73 ± 0.61a) 84.0 ± 12.8a) 0.416 ± 0.050a) 2 14/
6h		 RIA
[188]		 age > 1 year; AUC 6.784 ± 0.583a) min*mg/L [13]
5 6.0 ± 6.4 years 23.9 ± 19.0 120 IV, 30 sec 7.76 ± 0.89a) 64.0 ± 7.3a) 0.603 ± 0.138a) 2 14/
6h		 RIA
[188]		 age > 1 year; AUC 15.982 ± 1.760a) min*mg/L [13]
20 2.8 ± 1.5 years
(10 months – 6.5 years)		 23.0 ± 9.2 IV, bolus 11.1 ± 3.9 63 ± 24 1.07 ± 0.71 non 12/
5h		 RIA
[188]		 Orthopedic surgery patients;
Free fraction 11.5 ± 0.9 %		 [132]
18 2.8 ± 1.6 years 20 IV, bolus 10.9 ± 4.1 63 ± 25 1.07 ± 0.78 non 12/
5h		 RIA
[188]		 low dose (20 µg/kg) [132]
2 2.3 ± 0.6 years 50 IV, bolus 12.6 ± 1.1 60 ± 1 1.08 ± 0.08 non 12/
5h		 RIA
[188]		 high dose (50 µg/kg) [132]
8 5.4 ± 1.1 years 21.0 ± 3.2 20 IV, bolus 4.7 ± 1.7 40 ± 9 0.164 ± 0.110 2 16/
6h		 RIA
[188]		 Genitourinary surgery patients; plasma protein binding 94.4 ± 1.5 % @ 50 ng/mL, 92.4 ± 2.4% @ 500 ng/mL [131]
16 1d – 10.9 yearsc) 20/
100 ± 60/h		 IV, cont. 109b) (29–304) h 2.3 ± 2.8 294 ± 222 1.3 ± 0.9 non > 8/
> 48h		 RIA comparison of fentanyl and alfentanil, MRT 378 ± 294 min [136]
9 5.0 ± 2.8 years (9 months-10 years) 25–100 IV, 30 sec 5.6 ± 2.4 60 ± 11 0.48 ± 0.19 2 15/
4h		 RIA
[188]		 Surgical patients [135]
6 1–3 days 1.328 ± 0.546 25 IV, 30 sec 2.2 ± 2.4* 525 ± 305 1.0 ± 0.39 2 8/
12h		 RIA
[188]		 Preterm infants, GA 29.5 ± 3.3 wks [135]
13 1.5 ± 1.4 days 3.34 ± 0.97 8/
5.63 ± 1.88/h		 IV, 10 min, cont. (27 h) 3.24 ± 2.23 248 ± 155 0.54 ± 0.21 non 4+4/
24h+12h		 RIA
[188]		 Neonates, GA 37.6 ± 2.4 wks [134]
5 1 – 3 days 2.97 ± 1.14 25 IV, 30 sec 1.7 ± 0.47 328 ± 48 0.82 ± 0.30 non 9/
24h		 RIA
[188]		 GA 36.8 ± 0.98 wks; MRT 473 ± 70 min [143]
5 1 – 3 days 1.33 ± 0.59 25 IV, 30 sec 1.35 ± 0.69 455 ± 111 0.84 ± 0.48 non 9/
24h		 RIA
[188]		 Preterm infants, GA 29.3 ± 2.1 wks; MRT 657 ± 162 min [143]
22 1 – 4 days 1.343b) (0.69 – 4.084) 19.8b) (17.8–22.1) IV, 2 min 0.87b) (0.4–9.62) 321b) (64–1251) 0.50b) (0.13–1.04) 1/2 5–8/
7h		 RIA
[188]		 preterm infants, GA 30b) (25–36) wks; Cmax 66b) (20–606) ng/mL [142]
7 19b) (7–51) hours 2.3b) (1.46–3.32) 11b) (10–15) IV, 1 min 2.1b) (1.7–7.2) 43b) (34–237) 0.27b) (0.08–0.62) non 5/
6h		 CGC
[191]		 no muscle rigidity; mean GA 36 (30–40 wks) of all patients [144]
13 22b) (6–41) hours 2.4b) (1.69–3.95) 11b) (9–15) IV, 1 min 2.9b) (0.9–25.3) 153b) (31–650) 0.66b) (0.15–2.94) non 5/
6h		 CGC
[191]		 muscle rigidity; mean GA 36 (30–40 wks) of all patients [144]
10 5.0 ± 2.8 years (9 months – 10 years) 25–100 IV, 30 sec 7.25 ± 4.3 41.6 ± 16 0.40 ± 0.21 2 14/
2h		 RIA
[188]		 Surgical patients; AUC120/AUC∞ ratio 0.90 ± 0.05 [137]
9 4.6 ± 4.5 years (9 months – 15 years) 25–100 IV, 30 sec 7.59 ± 3.6 45.8 ± 13.3 0.46 ± 0.16 2 14/
2h		 RIA
[188]		 Cholestatic hepatic disease; AUC120/AUC∞ ratio 0.84 ± 0.08 [137]
3 25–100 IV, 30 sec 11.2 ± 2.7 41 ± 19 0.47 ± 0.23 2 14/
2h		 RIA
[188]		 Cholestatic hepatic disease, subgroup, before transplant [137]
3 25–100 IV, 30 sec 7.0 ± 3.8* 82 ± 38 0.83 ± 0.55 2 15/
2h		 RIA
[188]		 Cholestatic hepatic disease, subgroup, same patients, 8–12 h post-transplant; AUC120/AUC∞ ratio 0.71 ± 0.17 [137]
10 12.6 ± 3.2 years 25–100 IV, 30 sec 8.2 ± 4.4 41.5 ± 11 0.45 ± 0.10 2 14/
2h		 RIA
[188]		 End-stage renal disease;
AUC120/AUC∞ ratio 0.90 ± 0.07		 [137]
6 6.7 ± 2.7 months 6.5 ± 1.7 20/
60/h
(total: 998 ± 257)		 IV, bolus, cont. (130 ± 28 min) 8.2 ± 2.2 69 ± 25 0.48 ± 0.12 non > 4+14
> 0.25+6h		 CGC age < 1 year, CPB [149]
5 5.1 ± 1.9 years 18.6 ± 7.6 20/
60/h
(total: 3396 ± 1144)		 IV, bolus, cont. (147 ± 15 min) 6.3 ± 0.8 62 ± 9 0.31 ± 0.08 non > 4+14
> 0.25+6h		 CGC age > 1 year, CPB [149]
5 0.8 ± 0.3 years (4–11 months) 6.5 ± 1.2 200 IV, 10 min 2 > 6/
> 0.25h		 CGC Same cohort, before CPB; V1 0.068 ± 0.037 L/kg, AUC 17.9 ± 2.9 min*mg/L [148]
5 0.8 ± 0.3 years (4–11 months) 6.5 ± 1.2 80 IV, 10 min 11.5 ± 5.0 60 ± 18 0.63 ± 0.23 2 15/
6h		 CGC Same cohort, after CPB; V1 0.235 ± 0.058 L/kg, AUC 11.1 ± 2.9 min*mg/L [148]
6 4.1 ± 2.9 years (1–9 years) 15.8 ± 6.9 200 IV, 10 min 2 > 6/
> 0.25h		 CGC Same cohort, before CPB; V1 0.080 ± 0.032 L/kg, AUC 18.3 ± 5.4 min*mg/L [148]
6 4.1 ± 2.9 years (1–9 years) 15.8 ± 6.9 80 IV, 10 min 10.2 ± 4.6 48 ± 9 0.49 ± 0.10 2 15/
6h		 CGC Same cohort, after CPB; V1 0.179 ± 0.099 L/kg***, AUC 12.9 ± 3.4 min*mg/L*** compared to before CPB [148]
14 1.5 ± 2.2 years 8.7 ± 5.6 IV, cont. (TCI) 2.5 799 2.462 3 20–40/
24h		 RIA
[188]		 simple model; CL 2.4 mL/min/kg in CPB-adjusted model [190]
a)

mean ± SEM

b)

median data (range)

c)

demographics also include fentanyl group

Reported statistical significance is indicated as follows:

*

p < 0.05,

**

p < 0.005,

***

p < 0.001.