Fentanyl pharmacokinetics in anaesthetized patients with cirrhosis

Fentanyl kinetics were studied in patients with cirrhosis and in patients with normal hepatic and renal function undergoing surgery under general anaesthesia, the latter group served as the controls. Plasma fentanyl concentrations declined bi-exponentially in the controls with an average elimination half-life (T1/2 beta) of 263 min; total plasma clearance (Cl) as 10.8 ml min-1 kg-1, and total apparent volume of distribution (V beta) 3.81 litre kg-1. No significant change was observed in patients with cirrhosis: T1/2 beta was 304 min, Cl 11.3 ml min-1 kg-1 and V beta 4.41 litre kg-1. These data suggest that the elimination half-life of fentanyl is not primarily influenced by the rate at which it is metabolized in the liver.