经皮微创空心L形针刀治疗弹响指

目的探讨经皮微创空心L形针刀治疗弹响指的疗效。方法 2007年9月-2009年9月,采用自行设计的空心L形针刀微创治疗160例(202指)弹响指。男47例,女113例;年龄12～68岁,平均55岁。病程2周～1年。拇指58指,示指20指,中指46指,环指60指,小指18指。根据Quinnell分级标准:Ⅲ级63指,Ⅳ级126指,Ⅴ级13指。术中首先用空心L形针刀自皮下潜行至A1滑车部远端,向远端平行纵向切割后,自针刀空心向腱鞘部注入倍他米松。结果患者手术时间5～19 min,平均8.2 min;无手术相关并发症发生。160例均获随访,随访时间1年～3年6个月,平均1.6年。术后1周36指手术松解处疼痛,口服非甾体类消炎药后缓解。术后1周25指屈伸活动时仍存在扳机样感及顿挫感,1个月后5指恢复正常,20指症状无明显改善;其中10指再次行针刀治疗后症状缓解,余10指经1～3次针刀治疗后无缓解。术后6个月参照Quinnell分级标准评定疗效:获优165指,良27指,差10指,优良率为95.0%。结论经皮微创空心L形针刀治疗弹响指安全有效、易于操作。     

微创术治疗指屈肌腱狭窄性腱鞘炎98例

指屈肌腱狭窄性腱鞘炎,又名“弹响指”,传统治疗以局部封闭、理疗为主,但疗效欠佳,常规的手术治疗创伤大,术后易引起再粘连,影响疗效。因此,自1992年以来,我们采用自制的微针刀治疗此病98例,112个患指,损伤极小,疗效颇佳,现报导如下。     

甲床扩大术结合指侧方血管链皮瓣修复指端缺损

目的应用甲床扩大术结合指侧方血管链皮瓣修复指端缺损。方法自2010年8月至2012年9月,采用甲床扩大术结合指侧方血管链皮瓣修复指端缺损共10例12指,其中男6例8指,女4例4指;年龄21~53岁,平均34.6岁。切割伤3指,挤压伤7指,碾伤2指。结果所有皮瓣均成活,术后随访4~12个月,平均6个月。后期指甲生长良好,患指指端及指甲外观满意。结论甲床扩大术结合指侧方血管链皮瓣是治疗指端缺损的有效方法。     

关节镜下清理结合后路微创切除术治疗腘窝囊肿的临床疗效

目的探讨关节镜下清理结合后路微创切除术治疗腘窝囊肿的疗效。方法对37例腘窝囊肿患者行关节镜下清理结合后路微创切除术。根据Lysholm膝关节功能评分及Rauschning和Lindgren分级法对手术效果进行评定。结果 37例术后随访12~23个月,平均（17±2.3）个月,无1例复发。Lysholm评分术前为（53.7±3.6）分,术后6个月为（81.2±4.3）分,差异有统计学意义（P〈0.05）,Rauschning和Lindgren分级术前为Ⅱ级22例,Ⅲ级15例;术后6个月为0级21例,Ⅰ级13例,Ⅱ级3例。结论关节镜下清理结合后路微创切除术治疗腘窝囊肿具有术式简单安全、创伤较小、可针对关节内病损进行治疗、术后功能恢复良好、复发率低的优点。     

Ilizarov技术骨短缩-延长治疗无血管损伤的胫骨与软组织缺损

目的探讨Ilizarov技术骨短缩-延长治疗无血管损伤的胫骨与软组织缺损的疗效。方法回顾性分析2007年1月至2017年10月无锡市第九人民医院骨科采用Ilizarov技术骨短缩-延长治疗的28例无血管损伤的胫骨与软组织缺损患者资料。男20例,女8例;年龄18~69岁,平均36.4岁。均为创伤性骨折,GustiloⅡ型5例,ⅢA型6例,ⅢB型17例。17例合并感染。清创或扩创后创面皮缺损范围4 cm×3 cm^16 cm×5 cm,骨缺损长度4.5~11.0 cm(平均6.9 cm)。急性短缩3~7 cm后直接缝合或局部皮瓣转移或游离植皮,或术后逐渐短缩创口延迟闭合。术后观察创口愈合、骨愈合、下肢功能恢复和并发症等情况。骨愈合和下肢功能恢复分级按照Ilizarov技术研究与应用学会(ASAMI)标准分别评定。Ilizarov手术相关并发症按照Paley标准分为主要和次要并发症。结果创口愈合时间13~35 d(平均21.9 d),缺损端靠拢时间为0~75 d(平均21.8 d)。所有患者术后获12~45个月(平均20.5个月)随访。延长段骨愈合时间6~12个月(平均8.9个月);缺损端1例骨不连,骨愈合时间6~11个月(平均8.3个月)。ASAMI骨愈合分级优良率为100%(28/28),ASAMI下肢功能恢复优良率为89.3%(25/28)。Ilizarov术后主要并发症发生率为14.3%(4/28),次要并发症发生率为57.1%(16/28),总体并发症发生率为60.7%(17/28),并发症人次平均为1.7个/例。结论Ilizarov技术骨短缩-延长治疗无血管损伤的胫骨与软组织缺损,可以解决皮肤等软组织缺损修复困难难题,具有简化创口闭合、骨缺损端骨愈合较快、愈合率较高、并发症相对较少和肢体功能恢复满意等特点。     

骨巨细胞瘤术后复发的手术治疗

目的:探讨骨巨细胞瘤术后复发的手术方法及疗效。方法:1994年6月-2003年10月,收治四肢长骨复发性骨巨细胞瘤18例,男12例,女6例;年龄18~44岁,平均26岁。股骨下端5例,胫骨上端8例,股骨上端1例,桡骨远端4例。Enneking分期:Ⅰa期14例,Ⅰb期4例。放射影像学Cam-panicci分级:Ⅰ级7例,Ⅱ级7例,Ⅲ级4例。病理学Jaffe分级:Ⅰ级8例,Ⅱ级7例,Ⅲ级3例。采用肿瘤扩大切除,吻合血管的自体腓骨、髂骨联合移植术治疗9例;瘤段切除,吻合血管的腓骨头移植重建术4例;瘤段切除,人工假体置换术5例。结果:随访时间11~110个月,平均66个月。所有移植骨术后均愈合,一侧关节间隙轻度狭窄2例,术后再复发1例。术后功能评价:优13例,良3例,可1例,差1例。结论:肿瘤扩大切除,吻合血管的自体腓骨、髂骨联合移植术既能彻底切除病变,又能保持和重建关节功能,是一种较理想的方法,Campanicci分级Ⅲ级、病理学Jaffe分级Ⅱ~Ⅲ级的复发性骨巨细胞瘤原则上应施行更为广泛的瘤段切除术,桡骨远端复发性骨巨细胞瘤因其部位的特殊性,应用自体腓骨移植重建效果良好。     

微创穿刺引流术治疗急性硬膜外血肿86例

目的探讨微创穿刺引流术治疗硬膜外血肿的疗效。方法采用CT引导定位,血肿中心为靶点,YL-1型颅内血肿粉碎穿刺针经头皮穿刺冲洗粉碎引流联合尿激酶(2万~6万U)溶解血肿治疗硬膜外血肿86例。结果大血肿组(血肿量30~100 m l)44例,无效10例(22.7%,10/44),改行开颅血肿清除术后痊愈;余34例中术后3~5 d血肿引流干净25例,血肿少量残留(≤5 m l)9例。小血肿组(血肿量<30 m l)42例,术后1~3 d内均引流干净。出院时ADL分级:Ⅰ级72例,Ⅱ级14例。76例随访3~12个月,(5.3±3.7)月,按GOS分级均恢复良好。结论微创穿刺引流术治疗硬膜外血肿疗效确切、微创,准确选择适应证、把握手术时机至关重要。     

YL-1型针微创穿刺引流治疗急性硬膜外血肿的临床分析

目的探讨YL-1型针微创穿刺引流治疗急性硬膜外血肿的临床疗效。方法急性硬膜外血肿19例,采用CT引导定位,以血肿中心为靶点,YL-1型颅内血肿粉碎穿刺针经头皮穿刺冲洗、粉碎、引流血肿,并联合尿激酶(1×104~2×104U/次)溶解血肿。结果本组19例全部治愈,术后持续引流时间平均3.6(3~5)d,无一例需要输血,未出现术中大出血或术后血肿复发。无一例死亡,亦未发生颅内感染、张力性气颅等并发症。拔针前复查CT证实血肿清除90%~100%,占位效应消失或明显减轻。住院时间平均9.6(6~15)d。出院时日常生活量表(activity of daily living,ADL)分级:Ⅰ级17例,Ⅱ级2例。13例随访3~6月,平均(4.5±1.5)月,GOS分级均为Ⅰ级。结论 YL-1型针微创穿刺引流术治疗急性硬膜外血肿,疗效确切、微创、节省医疗费用,手术时准确选择适应证、把握手术时机非常重要。     

左侧肾癌合并Ⅰ～Ⅱ级下腔静脉癌栓的手术治疗方法

目的:探讨不同外科手术方式治疗左侧肾癌合并Ⅰ~Ⅱ级下腔静脉癌栓的安全性和有效性。方法:回顾性分析2015年2月~2018年2月我院收治的13例左肾癌合并Ⅰ~Ⅱ级下腔静脉癌栓患者的临床资料、围手术期参数及随访资料。本组男10例,女3例;年龄51~76岁,平均56.8岁;BMI 20.3~30.0kg/m2,平均23.9kg/m2;肿瘤最大直径5.0~21.1cm;平均10.3cm;术前肌酐水平73~194μmol/L,平均109μmol/L。应用影像学检查CT/MRI评估下腔静脉癌栓级别,应用Mayo分级对本组患者进行分级,其中MayoⅠ级7例,MayoⅡ级6例;术前评估采用美国麻醉医师协会分级标准(ASA分级),本组ASA分级1级2例,2级11例。手术方法为开放手术、腹腔镜手术联合开放手术及单纯腹腔镜手术。应用Clavien分级系统对患者术后早期并发症进行评估,术后每3个月对患者进行随访,复查血常规、肾功能等,应用胸部X-ray、腹部超声及PET-CT等评估肿瘤转移及复发情况。结果:所有患者手术均顺利完成,手术时间132~573 min,平均391 min;术中出血量20~2 500ml,平均805ml;共7例患者需要术中输血。在13例患者中,4例直接行开放经腹左肾癌根治性切除及下腔静脉癌栓取出术,9例先行后腹腔镜离断左肾动脉及游离肾脏,随后1例完全后腹腔镜下应用直线切割器处理下腔静脉癌栓,2例中转经腹腹腔镜手术行下腔静脉癌栓取出术,6例中转开放手术行下腔静脉癌栓取出术。术后病理结果为肾透明细胞癌10例,乳头状肾细胞癌3例,均为2型乳头状肾细胞癌。核分级Ⅱ级2例,Ⅲ级7例,Ⅳ级4例。本组5例患者发生术后早期并发症;13例患者均获随访,随访时间3~38个月,平均13个月。在随访过程中,1例术后6个月出现骨转移及肺转移进展,术后21个月因肿瘤进展死亡;2例分别于术后9个月和术后15个月发生肺转移,目前仍带瘤生存;其余10例规律随访未发生肿瘤复发及转移。结论:左肾癌根治性切除及下腔静脉癌栓取出术是治疗左肾癌合并Ⅰ~Ⅱ级下腔静脉癌栓安全、有效的方法,对于选择适当的患者及丰富腹腔镜手术经验的术者,行腹腔镜手术或腹腔镜联合开放手术是可行的。     

关节镜下前后联合与开放手术治疗腘窝囊肿的临床比较研究

目的比较关节镜下前后联合与传统开放手术治疗腘窝囊肿的临床疗效。方法笔者自2009-01—2012-12采用膝关节镜下前后路联合治疗腘窝囊肿108例（微创组）,并通过与2006-01—2008-12传统后路开放手术100例（开放组）比较临床疗效。结果开放组随访36~48个月,平均40个月;微创组随访5~42个月,平均37个月。末次随访时Rauschning和Lindgren分级：微创组0级97例,Ⅰ级8例,Ⅱ级3例;开放组0级72例,Ⅰ级18例,Ⅱ级10例;微创组疗效明显优于开放组,差异有统计学意义（P〈0.05）。微创组术后并发症明显少于开放组。结论关节镜下前后联合治疗与开放手术比较,具有临床疗效好、住院时间短、创伤小、复发率低等优点。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.