Pharmacokinetics of atracurium and laudanosine in patients with hepatic cirrhosis.

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 less than 0.05), as was the total volume of distribution (281.8 ml kg-1 and 202.1 ml kg-1, respectively) (P less than 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) (P less than 0.05), as was its elimination half-life (277 min in cirrhotic individuals; 168 min in controls) (P less than 0.05). There was no significant difference in the clearance of laudanosine between the two groups.