title: Pharmacokinetics and pharmacodynamics of vecuronium (ORG NC 45) in patients with cirrhosis.
abstract: To evaluate the effect of liver cirrhosis on the pharmacokinetics and the pharmacodynamics of vecuronium, 12 patients with cirrhosis, aged (mean +/- SD) 52 +/- 12 yr, and 14 control patients, 42 +/- 15 yr, undergoing elective surgery under general anesthesia were studied. The simultaneous time courses of the plasma concentration of vecuronium and of the neuromuscular blockade were studied after the administration of a bolus dose of 0.2 mg X kg-1. Vecuronium plasma concentration declined biexponentially in both groups. Vecuronium plasma clearance was reduced significantly (P less than 0.01) from 4.26 +/- 1.38 ml X min-1 X kg-1 in the controls to 2.73 +/- 1.19 ml X min-1 X kg-1 in the patients with cirrhosis. The elimination half-life was 58 +/- 19 min in the controls and was prolonged significantly to 84 +/- 23 min (P less than 0.01) in the patients with cirrhosis. The total apparent volume of distribution was unchanged in patients with cirrhosis (0.253 +/- 0.086 1 X kg-1 vs. 0.246 +/- 0.092 1 X kg-1 in the controls). Cirrhosis caused a prolongation of the neuromuscular blockade induced by vecuronium: the duration of effect from injection to 50% recovery of the twitch height was prolonged by 100% (P less than 0.01) from 62 +/- 16 min in the controls to 130 +/- 52 min in patients with cirrhosis. The recovery rate (TH 25-75) also was prolonged (P less than 0.05) from 21 +/- 7 min in the controls to 44 +/- 18 min in patients with cirrhosis.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.forename: C
authors.initials: C
authors.lastname: Lebrault
authors.forename: J L
authors.initials: JL
authors.lastname: Berger
authors.forename: A A
authors.initials: AA
authors.lastname: D'Hollander
authors.forename: R
authors.initials: R
authors.lastname: Gomeni
authors.forename: D
authors.initials: D
authors.lastname: Henzel
authors.forename: P
authors.initials: P
authors.lastname: Duvaldestin
mesh_terms: D000328:Adult; D000368:Aged; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006207:Half-Life; D006801:Humans; D007700:Kinetics; D008104:Liver Cirrhosis, Alcoholic / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000187:drug effects; D009469:Neuromuscular Junction / Q000187:drug effects*; D010197:Pancuronium / Q000031:analogs & derivatives* / Q000097:blood / Q000494:pharmacology; D013050:Spectrometry, Fluorescence; D014673:Vecuronium Bromide
chemical_list: D014673:Vecuronium Bromide; D010197:Pancuronium