The dose of all of the following local anesthetic should be decreased in patients with deranged liver function except-
procaine is the only amino ester local anesthetic. All Aminoester compounds are hydrolyzed by plasma cholinesterase (pseudocholinesterase or butyrylcholinesterase) except cocaine which is paially metabolized by hepatic carboxylesterase and paially excreted unexchanged in the urine. Amino Amide local anesthetics like lidocaine, bupivacaine, ropivacaine, prilocaine are metabolized (N-dealkylation and hydroxylation) by microsomal P-450 enzymes in the liver.
Lignocaine
Bupivacaine
Cocaine
Procaine
Regional Anesthesia