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British Journal of Anaesthesia, 1989, Vol. 63, No. 4 375-379
© 1989 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

PHARMACOKINETICS OF MORPHINE IN PATIENTS FOLLOWING ORTHOTOPIC LIVER TRANSPLANTATION

M. P. SHELLY, F.F.A.R.C.S.*, K. G. QUINN, M.SC. and G. R. PARK, M.A., F.F.A.R.C.S.

Department of Anaesthesia, Addenbrookes Hospital Hills Road, Cambridge CB2 2QQ

*Present address: Shackleton Department of Anaesthetics, Southampton General Hospital, Tremona Road, Southampton.

Plasma and urine concentrations of morphine, morphine-3-glucuronide and morphine-6-glucuronide were measured in seven patients after orthotopic liver transplantation. After a single i.v. bolus of morphine sulphate 10 mg a biexponential decay was observed. Although the distribution and elimination half-lives for morphine were similar to those described in previous studies, a greater total apparent volume of distribution was observed. This was reflected in a greater plasma clearance of morphine than has been reported previously. The concentration of morphine glucuronides remained increased 24 h after administration of morphine; the clinical significance of this remains to be established. The metabolism of morphine was virtually complete, with 4.5% unchanged morphine recovered in urine 24 h after drug administration.


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