THE MONOETHYLGLYCINEXYLIDIDE TEST IS MORE USEFUL FOR EVALUATING LIVER-FUNCTION THAN INDOCYANINE GREEN TEST - CASE OF A PATIENT WITH REMARKABLY DECREASED INDOCYANINE GREEN HALF-LIFE

Lidocaine was used for evaluation of hepatic function in a patient und ergoing hepatic resection. Preoperatively, half-life of indocyanine gr een (ICG) was 33 min after intravenous administration. Plasma concentr ation of the N-dealkylated metabolite of lidocaine, monoethylglycinexy lidide (MEGX), was quantitatively determined to evaluate hepatic funct ion. The patient's rate of formation of MEGX at 15 min after administr ation of lidocaine was within normal limits, at 56 mu g/L. These findi ngs suggest that in this patient, hepatic cytochrome P-450IIIA activit y was not impaired, but selective impairment of uptake of ICG into hep atocytes or excretion into the bile ducts was present, The rate of for mation of MEGX was decreased, and plasma concentration of bilirubin wa s elevated postsurgically; this could have been the result of decrease d cytochrome P-450IIIA activity or decreased hepatic blood flow after hepatic resection. We conclude that the rate of formation of MEGX is a better index of hepatic function than is ICG half-life.