This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Regional Anesthesia, Subject name: Anaesthesia
[{'content': 'The dose of all of the following local anesthetic should be decreased in patients with deranged liver function except- \nSelect and explain. \nA. Lignocaine, B. Bupivacaine, C. Cocaine, D. Procaine', 'role': 'user'}, {'content': 'Answer: D \nExplanation: 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.', 'role': 'assistant'}]