• O Y Hu, S T Ho, J J Wang, W Ho, H J Wang, and C Y Lin.
• School of Pharmacy, National Defense Medical Center, Taipei, Taiwan, Republic of China.
• Crit. Care Med. 1993 Apr 1;21(4):527-31.

ObjectiveThe aim of this study was to evaluate the possible effect of a severe burn on gastric emptying by determining the absorption kinetics of orally administered acetaminophen.DesignA prospective, controlled study.SettingA ten-bed burn center in a 1,300-bed university hospital.PatientsTen adult patients suffering from second-degree burn involving > 20% of total body surface area and 20 normal, healthy volunteers who acted as controls.InterventionsPatients received routine treatment such as nutritional support and cimetidine. However, opiates were stopped for at least 12 hrs before the start of the study, and nonsteroidal anti-inflammatory drugs as alternatives were used. After an 8-hr fast, the subjects ingested 0.5 g acetaminophen with 200 mL of water. The plasma concentrations of acetaminophen were determined by high-performance liquid chromatography, and the absorption kinetics was estimated from determination of time to reach the maximum plasma concentration, the maximum plasma concentration, and the area under the plasma concentration-time curve.Measurements And Main ResultsThe mean time for reaching the maximum plasma concentration was 33 +/- 24 (SD) mins in patients and 39 +/- 24 mins in the healthy volunteers. The mean area under the plasma concentration-time curve from time 0 to 120 mins and the mean maximum plasma concentration were 556 +/- 190 micrograms/mL/min and 9.5 +/- 3.5 micrograms/mL in patients, and 539 +/- 131 micrograms/mL/min and 7.8 +/- 2.8 micrograms/mL in volunteers, respectively. There was no statistical difference between groups in the time to reach the maximum plasma concentration, the area under the plasma concentration-time curve from time 0 to 120 mins, and the maximum plasma concentration. The time for reaching the maximum plasma concentration was not correlated with the severity of the burn (% area of burn) and the duration of healing (days) after burn.ConclusionsWe conclude that severe burn injury does not affect the kinetics of gastric emptying, and that 200 mL of water ingested 2 hrs before anesthesia is quite safe in severely burned patients. Also, the absorption kinetics of acetaminophen was not altered by burn injury.

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