Figure 11-23 Time-dependent changes of blood concentration of remifentanil in patients with liver disease (top graph) and the control subjects (bottom graph). In the low-dose group, remifentanil was infused at 0.0125 µg/kg/minute for 1 hour followed by 0.025 µg/kg/minute for 3 hours. In the high-dose group, infusion rate of remifentanil was 0.025 µg/kg/minute for 1 hour followed by 0.05 µg/kg/minutes for 3 hours. (From Dershwitz M, Hoke JF, Rosow CE, et al: Pharmacokinetics and pharmacodynamics of remifentanil in volunteer subjects with severe liver disease. Anesthesiology 84:812–820, 1996.)