The pharmacokinetics and neuromuscular effects of rocuronium bromide in patients with liver disease.

Abstract:

:To determine the effect of liver disease on the pharmacokinetics of rocuronium, the authors administered 0.6 mg/kg (twice the ED95) to 10 patients with liver disease and compared these results to values in 10 healthy surgical patients. Anesthesia was induced with thiopental and maintained with isoflurane (0.9%-1.1% end-tidal concentration) and nitrous oxide (60%). Venous blood samples were obtained for 6 h after rocuronium injection and plasma concentrations were measured using gas chromatography. Pharmacokinetic differences between groups were determined using a population-based pharmacokinetic analysis (NONMEM). Hepatic impairment did not alter the plasma clearance of rocuronium (217 +/- 21.8 mL/min, mean +/- SE, for both groups), but did increase the volume of the central compartment (5.96 +/- 1.01 L for controls, 7.87 +/- 1.33 L for patients with liver disease) and volume of distribution at steady state (16.4 L for controls, 23.4 L for patients with liver disease). In turn, elimination half-life was longer in patients with liver disease (111 min) compared to controls (75.4 min). The authors conclude that liver disease alters the pharmacokinetics of rocuronium by increasing its volume of distribution. The longer elimination half-life might result in a longer duration of action of rocuronium in patients with liver disease, particularly after prolonged administration.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Magorian T,Wood P,Caldwell J,Fisher D,Segredo V,Szenohradszky J,Sharma M,Gruenke L,Miller R

doi

10.1097/00000539-199504000-00018

subject

Has Abstract

pub_date

1995-04-01 00:00:00

pages

754-9

issue

4

eissn

0003-2999

issn

1526-7598

journal_volume

80

pub_type

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