Effect of Hypotension on Liver Blood Flow and Lidocaine Disposition

Abstract

IN comparison to other highly vascular organs, the liver has a limited ability to autoregulate blood flow in the presence of hypotension.¹ This may have important consequences for the clearance of drugs that are highly extracted by the liver, such as lidocaine, meperidine, morphine, and propranolol, and whose systemic elimination is dependent on liver blood flow.^{2 , 3} Thus, in congestive heart failure,⁴ in which liver blood flow falls in proportion to the reduction in cardiac output,⁵ and in experimental hypotension due to hemorrhage in animals,⁶ the clearance of lidocaine is markedly reduced. Since these drugs are commonly given to patients with . . .