Hunter J M
University Department of Anaesthesia, Royal Liverpool University Hospital, UK.
Eur J Anaesthesiol Suppl. 1995 Sep;11:39-41.
The pharmacokinetics of aminosteroid neuromuscular blocking drugs have been shown to be altered in patients with hepatic cirrhosis. A reduced clearance and prolonged elimination half-life of pancuronium and vecuronium have been demonstrated. Pharmacokinetic studies of the newest aminosteroid neuromuscular blocking agent, rocuronium, performed in a small number of cirrhotic patients, have proved inconclusive, apart from noting a higher central volume of distribution than in healthy patients. This difference may result in a slightly delayed onset of neuromuscular block. Nevertheless, rocuronium, even in cirrhotic patients, has the fastest onset of action of any non-depolarizing neuromuscular blocking agent. Further pharmacokinetic studies are necessary of this drug in hepatic cirrhosis.
已表明，肝硬化患者中甾体类神经肌肉阻滞药物的药代动力学发生了改变。泮库溴铵和维库溴铵的清除率降低，消除半衰期延长。对少数肝硬化患者进行的最新甾体类神经肌肉阻滞剂罗库溴铵的药代动力学研究结果尚无定论，仅发现其中心分布容积高于健康患者。这种差异可能导致神经肌肉阻滞的起效略有延迟。然而，即使在肝硬化患者中，罗库溴铵仍是所有非去极化神经肌肉阻滞剂中起效最快的。有必要对这种药物在肝硬化患者中的药代动力学进行进一步研究。
