Etomidate anaesthesia in patients with cirrhosis of the liver: pharmacokinetic data.
Five patients undergoing endoscopic injection of oesophageal varices were anaesthetised with etomidate 0.2 mg/kg followed by an infusion at a rate of 20 micrograms/kg/minute. Fentanyl 100-200 micrograms was also given intravenously and the patients' lungs were ventilated with oxygen in air. The postinfusion plasma etomidate concentration was described by a three compartment model with a mean half-life of 540 minutes (SEM 66.9) and volume of distribution of 8.9 litres/kg (SEM 0.6). Clearance was 12.7 ml/kg/minute (SEM 2.3). Compared to results in the literature obtained from normal patients, these cirrhotic patients had normal clearance rates, but the distribution volume and elimination half-life were twice as great. This suggests that cirrhotic patients metabolise etomidate normally, but the volume of distribution is doubled, thus resulting in prolonged elimination half-lives.
D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D004932:Esophageal and Gastric Varices / Q000628:therapy; D005045:Etomidate / Q000097:blood*; D006207:Half-Life; D006801:Humans; D007093:Imidazoles / Q000097:blood*; D007700:Kinetics; D008099:Liver / Q000201:enzymology; D008103:Liver Cirrhosis / Q000097:blood*; D008657:Metabolic Clearance Rate; D008954:Models, Biological
D007093:Imidazoles; D005045:Etomidate