The pharmacokinetics of intravenous ketorolac in children aged 2 months to 16 years: A population analysis
Bibliographic record
Abstract
Summary Background Intravenous ketorolac is commonly administered to children for the control of postoperative pain. An effect siteEC50for analgesia of 0.37 mg.L−1is described in adults. Aims The aim of this study was to review age‐ and weight‐related effects on ketorolac pharmacokinetic parameters in children and current dosing schedules. Methods Pooled intravenous ketorolac (0.5 mg.kg−1) concentration‐time data in children aged 2 months to 16 years were analyzed using nonlinear mixed‐effects models. Allometry was used to scale to a 70 kg person. Results There were 64 children aged 2 months to 16 years (641 plasma concentrations) available for analysis. A two‐compartment mammillary model was used to describe pharmacokinetics. Clearance was 2.53 (CV45.9%) L.h−1.70 kg−1and intercompartment clearance was 4.43 (CV95.6%) L.h−1.70 kg−1. Both central (V1) and peripheral (V2) volumes of distribution decreased with age over the first few years of postnatal life to reach V1 6.89 (CV30.3%) L.70 kg−1and V2 5.53 (CV47.6%) L.70 kg−1. Conclusion Clearance, expressed as L.h−1.kg−1, decreased with age from infancy. A dosing regimen of 0.5 mg.kg−1every 6 hours maintains a trough concentration larger than 0.37 mg.L−1in children 9 months to 16 years of age. This dosing regimen is consistent with current recommendations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".