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document
The low-dose monoethylglycinexylidide test : assessment of liver function with fewer side effects . The hepatic metabolism of lidocaine ( 1 mg/kg intravenously ) to its metabolite monoethylglycinexylidide ( MEG-X ) is the basis of the standard MEG-X test . To reduce the lidocaine-induced side effects , we evaluated the MEG-X formation after 0.5 and 1 mg/kg lidocaine intravenously in subjects with normal ( n = 5 ) and severely impaired liver function ( n = 7 ) ( study I ) . From this study , a low-dose test ( MEG-X concentration 30 minutes after 50 mg lidocaine intravenously [ MEG-X30min ] normalized to standard MEG-X test results ) was developed . Sensory side effects from this low dose and from the standard MEG-X test were compared in a double-blind , randomized , cross-over study ( study II ) comprising 15 individuals with normal liver function and 45 patients with cirrhosis ( 15 Child A , 15 Child B , and 15 Child C ) . In study I , MEG-X formation rate was dose-independent in patients with severely impaired liver function . In study II , normalized MEG-X test results ( ranging from < or = 4 to 120 microg/L ) were virtually identical to the standard test results ( mean difference : -1.9 microg/L ; 95 % confidence interval [ CI ] : -5.3 ; 1.5 microg/L ) . Fewer individuals experienced side effects ( 30 % vs. 53 % ) with the low-dose test ( P = .0013 ) . In a multivariate analysis , the Child-Pugh score was inversely related to the occurrence of side effects . The low-dose MEG-X test gives almost identical results to the standard MEG-X test and is associated with fewer side effects , which occur less often in individuals with more severely compromised liver function .
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Intervention_Pharmacological
lidocaine
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Intervention_Pharmacological
monoethylglycinexylidide ( MEG-X )
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Intervention_Pharmacological
MEG-X
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Intervention_Pharmacological
lidocaine-induced
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Intervention_Pharmacological
MEG-X
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Intervention_Pharmacological
MEG-X
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Intervention_Pharmacological
lidocaine
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Intervention_Pharmacological
MEG-X30min
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Intervention_Pharmacological
MEG-X
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Intervention_Pharmacological
MEG-X
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Outcome_Physical
assessment
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Outcome_Physical
MEG-X formation rate
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Outcome_Adverse-effects
Child-Pugh score
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Outcome_Physical
side effects .
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Outcome_Physical
fewer side effects