Hemodynamic and pharmacokinetic analysis of oxymetazoline use during nasal surgery in children

The Laryngoscope
Richard S CartabukeJoseph D Tobias

Abstract

Oxymetazoline is an α-adrenergic agonist that is commonly used as a topical hemostatic agent in the operating room during ear, nose, and throat surgery. There are limited data on oxymetazoline pharmacokinetics in children who undergo general anesthesia. We assessed the hemodynamic effects and systemic absorption of topically applied oxymetazoline in children undergoing various nasal procedures. Prospective trial. Children ages 2 to 17 years undergoing functional endoscopic sinus surgery, turbinate resection, or adenoidectomy were enrolled. The surgeon placed oxymetazoline-soaked pledgets (1.5 mL of 0.05% solution) according to our usual clinical practice. Blood samples for oxymetazoline assay were drawn at 5, 10, 20, 45, 90, and 150 minutes, and hemodynamic data were recorded at 5-minute intervals. Data analysis included mixed-effects regression and population pharmacokinetic/pharmacodynamic modeling. The analysis included 27 patients, age 7 ± 4 years, who received between 2 and 12 pledgets (3-18 mL) of oxymetazoline. Relative bioavailability compared to the spray formulation was 2.3 (95% confidence interval [CI]: 1.6-3.2), with slow absorption from the mucosal surface (absorption half-life 64 minutes; 95% CI: 44-90). Mean arte...Continue Reading

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Citations

Apr 4, 2020·South African Family Practice : Official Journal of the South African Academy of Family Practice/Primary Care·Robin J GreenGuy A Richards
Apr 4, 2021·Journal of Clinical Medicine·Robert S Jones
Oct 6, 2021·Pediatrics·Richard CartabukeUNKNOWN SECTION ON ANESTHESIOLOGY AND PAIN MEDICINE, SECTION ON OTOLARYNGOLOGY–HEAD AND NECK SURGERY

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