Lidocaine Intraoperative Infusion Pharmacokinetics during Partial Hepatectomy for Living Liver Donation
Authors' conclusion
Clearance of lidocaine is decreased proportionally to the remaining liver mass, which should guide lidocaine infusion administration or dosing adjustments for patients undergoing liver resection surgery.
Study context
- Population
- Patients undergoing open partial hepatectomy for living liver donation receiving intraoperative IV lidocaine infusion
- Participants
- 15 patients
- Outcome
- Elimination clearance of lidocaine and its metabolites (monoethylglycinexylidide, glycinexylidide) after partial hepatectomy
Methodological detailspopulation pharmacokinetic modelling
- Population pharmacokinetic modelling
Main finding
As reported in the abstract
Lidocaine elimination clearance
Typical lidocaine elimination clearance, baseline (± SE of the estimate)
0.55 ± 0.12 l/min
Clearance once donor graft surgically isolated, about one third of baseline, remained so for 24 h (± SE)
0.17 ± 0.02 l/min
Further findings
Time course of plasma concentrations
- Plasma lidocaine concentrations decreased at case end and postoperatively; metabolite concentrations continued to rise at end of surgery, with reduction postoperatively
Safety
Toxic plasma concentrations of lidocaine and metabolites · up to 24 h after surgery
- Below theoretical combined toxic threshold throughout surgical and postoperative course in all patients, with one exception obtained near induction of anesthesia
Original publication
Lidocaine Intraoperative Infusion Pharmacokinetics during Partial Hepatectomy for Living Liver Donation. Anesthesiology. Published 27 October 2022. doi:10.
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