Pharmacokinetics of midazolam in patients with liver damage for hepatectomy

Pharmacokinetics of midazolam in patients with liver damage for hepatectomy was compared to that in patients without liver injury for gastrectomy. Anesthesia was induced with midazolam 0.15 mg · kg^-1 and fentanyl. Serum concentration of midazolam was measured at 30 minutes, 1, 2, 3, 4, 6 and 8 hours after midazolam injection. Serum midazolam levels were not significantly different between the two groups at any time. The elimination half-life of midazolam was about 3 times longer in hepatectomy group (24.2 hours) than in the group without liver injury (8.4 hours). Area under the curve of the serum midazolam concentration was larger in the group with liver damage than in the group without it. But distribution volume and clearance of midazolam were not different between the two groups probably because of more blood transfusion and bleeding in hepatectomy group. The recovery time from anesthesia in hepatectomy group was as long as that in the group without liver injury. The results suggest that in patients with liver damage for hepatectomy, the elimination of midazolam is prolonged but its effect is not.