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British Journal of Anaesthesia, 1989, Vol. 62, No. 2 177-183
© 1989 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

PHARMACOKINETICS OF ATRACURIUM AND LAUDANOSINE IN PATIENTS WITH HEPATIC CIRRHOSIS

C. J. R. PARKER, M.B., F.F.A.R.C.S. and J. M. HUNTER, M.B., F.F.A.R.C.S.

University Department of Anaesthesia, Royal Liverpool Hospital Prescot Street, P.O. Box 147, Liverpool L69 3BX

The pharmacokinetic profiles of atracurium and one of its derivatives, laudanosine were studied following an i.v. bolus of atracurium 0.6 mg kg–1 administered to eight patients with hepatic cirrhosis and to seven healthy controls. The central volume of distribution of atracurium was greater in the patients with cirrhosis (104.6 ml kg–1) compared with the controls (69.6 ml kg–1) (P < 0.05), as was the total volume of distribution (281.8 ml kg–1 and 202.1 ml kg–1, respectively) (P < 0.05). There was no significant difference in the elimination half-life of atracurium between the two groups. The total volume of distribution of laudanosine was increased in cirrhotic patients (2.68 litre kg–1) compared with healthy controls (1.97 litre kg–1) (P < 0.05), as was its elimination half-life (277 min in cirrhotic individuals; 168 min in controls) (P < 0.05). There was no significant difference in the clearance of laudanosine between the two groups.


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