Pharmacokinetics of atracurium and laudanosine in patients with hepatic cirrhosis

Abstract

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. © 1989 British Journal of Anaesthesia.