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LETTER TO THE EDITOR

Factors Affecting Morphine Metabolism Following Major Liver Resection

Department of Anesthesiology and Intensive Care; Lund University Hospital, Sweden (Rudin) Department of Oncology; Lund University Hospital, Sweden; asa.rudin{at}skane.se (Werner)

In Response:

We appreciate Fawcett et al’s suggestions1 regarding our study2 since morphine pharmacokinetics after liver resection and its clinical consequences have not been systematically studied.

Our surgeons used Pringle’s maneuver in patients with intraoperative bleeding problems, and we do not believe that this procedure significantly affected the pharmacokinetic variables studied. Although we used the volume of liver resection as a clinically relevant indicator of immediate reduction in liver function, we do agree that it would be interesting to correlate standard tests of liver function with delayed impairment of postoperative morphine metabolism.

REFERENCES

1. Quiney NF, Patel A, Fawcett W. Factors affecting morphine metabolism following major liver resection. Anesth Analg 2008; 106:348–349[Free Full Text]
2. Rudin A, Lundberg JF, Hammarlund-Udenaes M, Flisberg P, Werner MU. Morphine metabolism after major liver surgery. Anesth Analg 2007;104:1409–14[Abstract/Free Full Text]

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