Pharmacokinetics is a first, but essential step to improve population-tailored postoperative analgesia, also after Caesarean delivery.\r\nWe therefore aimed to quantify the impact of caesarean delivery on the pharmacokinetics of intravenous (iv) paracetamol (2 g,\r\nsingle dose) and iv ketorolac tromethamine (30 mg, single dose) in 2 cohorts eachof 8 women at caesarean delivery and to\r\ncompare these findings with postpartum to quantify intrapatient changes.We documented a higher median paracetamol clearance\r\nat delivery when compared to 10ââ?¬â??15 weeks postpartum (11.7 to 6.4 L/hÃ?·m2, P < 0.01), even after correction for weight-related\r\nchanges. Similar conclusions were drawn for ketorolac: median clearance was higher at delivery with a subsequent decrease (2.03\r\nto 1.43 L/hÃ?·m2, P < 0.05) in postpartum (17ââ?¬â??23 weeks). These differences likely reflect pregnancy- and caesarean-delivery-related\r\nchanges in drug disposition. Moreover, postpartum paracetamol clearance was significantly lower when compared to estimates\r\npublished in healthy young volunteers (6.4 versus 9.6 L/hÃ?·m2), while this was not the case for ketorolac (1.43 versus 1.48 L/hÃ?·m2).\r\nThis suggests that postpartum is another specific status in young women that merits focused, compound-specific pharmacokinetic\r\nevaluation.
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