Pharmacokinetic basis of intravenous lidocaine administration as 1 mg/kg for assessment of liver condition in patients with liver cirrhosis and/or fibrosis. Part I

ABSTRACT

The pharmacokinetics of lidocaine administered intravenously as bolus in a dose of 1 mg/kg body weight for assessment of severity of liver disease was evaluated in patients with liver cirrhosis and/or fibrosis [n = 66]compared with healthy volunteers [n = 20]. Two methods of pharmacokinetic analysis were used, two compartment [2C] and model independent[MI] methods. The alteration in lidocaine pharmacokinetics based on MI calculations were more fitting with pathological changes in the liver. In chronic liver diseased patients compared with the control subjects, the elimination half life of lidocaine was significantly prolonged [128 vs 68 minutes, respectively] and clearance was significantly reduced [5.1 vs 10.1 mm/minutes/kg, respectively]. When patients were categorized according to Child-Pugh classification, delay in the elimination of the drug was observed significantly in advanced liver injury [Child B and C groups] compared with Child A. Additionally, liver cirrhosis either alone or when mixed with schistosomal hepatic fibrosis impaired the elimination of lidocaine in a significant way compared with pure schistosomal hepatic fibrosis. Therefore, lidocaine could be used as a marker to evaluate the severity of liver injury based on the study of its disposition in liver diseases