PHARMACOKINETICS OF ATRACURIUM AND LAUDANOSINE IN PATIENTS WITH HEPATIC CIRRHOSIS

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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.