关节镜下克氏针结合缝线不经骨骺线固定治疗儿童胫骨髁间隆突骨折

目的:探讨膝关节镜下单枚克氏针加缝线不经过骨骺线固定治疗儿童胫骨髁间隆突骨折的技术及临床应用效果。方法:自2008年5月至2012年12月治疗21例儿童胫骨髁间隆突骨折, 年龄6～14岁, 男13例, 女8例。根据Meyers-McKeever骨折分型:Ⅱ型7例, Ⅲ型10例, Ⅳ型4例。手术均采用关节镜下复位, 单枚克氏针加缝线不经过骨骺线固定。术后1周积极开始功能锻炼, 并随访10～30个月, 术后1、3、6个月摄X线片观察骨折愈合情况, 记录关节活动度、前抽屉试验、Lachman试验、关节功能Lysholm评分, 评价临床效果。结果:术后6周, 21例胫骨髁间隆突骨折均愈合, 无骨折移位。术后3个月, 前抽屉试验、Lachman试验均阴性。术后6个月, Lysholm膝关节功能评分93.3±5.2,复查X线片未见骨骺线增宽或变窄。结论:关节镜下单枚克氏针加"8"字缝线不经过骨骺线固定治疗儿童胫骨髁间隆突骨折, 复位和固定可靠, 不经过骨骺线, 手术创伤小, 对骨骺干扰小, 能够早期关节功能锻炼, 疗效满意。     

选择性胫骨外髁U形截骨入路治疗胫骨外侧平台塌陷粉碎骨折

目的:探讨选择性胫骨外髁"U "形截骨入路治疗胫骨外侧平台塌陷粉碎骨折的方法和临床疗效。方法:自2014年1月至2019年10月,采用选择性胫骨外髁" U"形截骨入路对15例胫骨外侧平台塌陷粉碎骨折患者进行手术治疗,其中男9例,女6例;年龄25~70(38.5±7.7)岁。按照胫骨平台外侧髁骨折ABC分型,A型2例,B型6例,BC型4例,C型3例;合并内侧平台骨折5例;左膝8例,右膝7例。伤后至就诊时间1~14(3.4±1.2) d。所有患者CT提示胫骨外侧平台塌陷>2 mm,粉碎骨块>2块,胫骨外侧髁皮质完整。术后12个月采用Rasmussen骨折复位解剖学评分评价骨折复位情况,并采用Rasmussen功能评分评价膝关节功能。结果:15例患者选择性"U "形截骨一次成功,手术时间55~110(85.6±20.0) min,外侧平台手术时间20~60(30.5±10.5) min。所有患者获随访,时间12~24(14.6±2.5)个月。骨折愈合时间12~24(13.6±3.6)周。术后12个月膝关节Rasmussen骨折复位解剖学评分14~18(17.5±0.3)分,其中优13例,良2例。膝关节Rasmussen功能评分13~30(26.8±2.5)分;其中优12例,良1例,可2例。2例外侧平台高度分别丢失2 mm和4 mm,1例膝关节5°外翻畸形,1例关节僵硬(10°~100°)。未发生腓总神经损伤、腘血管损伤,术后无感染、内固定失效等严重并发症。结论:采用选择性胫骨外髁" U"形截骨入路治疗胫骨外侧平台塌陷粉碎性骨折,具有手术切口简单、骨折显露直接、复位固定准确、手术时间短,并发症少等优点,是一种有效、可靠的方法。     

胫骨平台骨折手术治疗及疗效分析

目的总结胫骨平台骨折手术治疗的临床结果,分析影响手术效果的因素。方法回顾分析2001年1月～2003年12月收治的39例胫骨平台骨折手术患者,骨折类型按Schatzker分型,Ⅰ型5例,Ⅱ型12例,Ⅲ型8例,Ⅳ型5例,Ⅴ型6例,Ⅵ型3例。Ⅰ型患者采用闭合复位空心加压螺钉内固定,Ⅲ型有3例患者在关节镜下复位植骨石膏外固定。其余病例分别采用切开复位,钢板内固定,有骨缺损者自体植骨。术后3个月开始部分负重,5个月完全负重。结果39例患者均获随访,平均时间1.8年,采用Rasmussen临床和放射评分方法,优良率分别为89.7%和87.2%。4例患者出现创伤性骨性关节炎,2例患者有严重的骨质疏松,术后出现不同程度关节面塌陷。结论手术是治疗胫骨平台骨折的有效方法,稳定的内固定,尽可能减少对骨折块的血运干扰,保护关节附属结构,正确关节功能康复治疗,对提高疗效有明显影响。     

不同微创方法治疗第5掌骨颈部骨折的疗效分析

目的：探讨手法复位克氏针微创治疗第5掌骨颈部骨折的有效方法。方法：自2018年1月至2021年11月采用手法闭合复位克氏针微创治疗第5掌骨颈部闭合性骨折患者90例,骨折AO分型均为A型。根据克氏针内固定方式分为3组：交叉克氏针组30例,横向克氏针组30例,髓内克氏针组30例,各组性别、年龄、病程、术前颈干角等基线资料比较差异无统计学意义（P>0.05）。观察并比较各组患者术后12个月第5掌骨颈干角、第5掌指关节屈曲活动度和第5掌指关节伸直欠伸角度。根据手-前臂手术疗效评分系统（patient outcomes of surgery-hand/arm,POS-Hand/Arm）进行临床疗效评价。结果：所有患者获得术后12个月随访,均骨性愈合,无畸形愈合。3组患者术后12个月第5掌骨颈干角和掌指关节屈曲角度、掌指关节伸指欠伸角度组间比较,差异无统计学意义（P>0.05）。术后12个月3组POS-Hand/Arm评分中身体活动和症状评分比较差异无统计学意义（P>0.05）;心理状况和美观评分：3组比较差异有统计学意义（P<0.05）,交叉克氏针组和横向克氏针组比较差异无统计学意义（P>0.05）。术后12个月POS-Hand/Arm总评分：3组比较差异有统计学意义（P<0.05）,交叉克氏针组和横向克氏针组比较差异无统计学意义（P>0.05）,髓内克氏针组患者POS-Hand/Arm总评分最高。结论：三种克氏针固定技术均能达到微创治疗的目的,患者对美容和早期活动有需求,推荐手法复位克氏针微创髓内固定为首选术式。     

双钢板固定治疗胫骨平台SchatzkerⅥ型骨折

目的探讨双钢板固定治疗胫骨平台SchatzkerⅥ型骨折的方法和临床疗效。方法回顾分析2007年5月至2010年3月收治的胫骨平台SchatzkerⅥ型骨折28例。术前CT扫描明确骨折具体部位、关节塌陷移位程度。所有病例均接受胫骨近端内外侧双钢板螺钉固定、自体髂骨植骨,3例结合克氏针辅助固定。结果 28例患者术后随访12～30个月(平均16.5个月)。骨折愈合时间平均为3个月,完全负重时间平均为3.6个月。术后1年根据美国纽约特种外科医院(HSS)膝关节功能评分评定疗效,优22例,良4例,中2例,优良率为92.9%。术后即刻胫骨平台内翻角、胫骨平台后倾角与术后1年相比,无统计学意义(P>0.05)。结论术前CT扫描对SchatzkerⅥ型胫骨平台骨折手术治疗具有明确指导作用。双钢板治疗可减少对胫前皮瓣和骨折端血供的破坏,坚强固定和良好植骨能避免关节面二期塌陷和膝关节力轴对线不良,早期合理的功能锻炼有助于提高疗效。     

钢板内固定联合磷酸钙骨水泥治疗胫骨平台骨折的疗效

目的探讨钢板内固定联合磷酸钙骨水泥治疗胫骨平台骨折的临床疗效。方法采用钢板内固定联合磷酸钙骨水泥填充关节面塌陷治疗38例胫骨平台骨折患者。结果患者均获得随访,时间15～24个月。术后6个月患者均可完全负重行走。骨折骨性愈合时间为6～8个月。末次随访时,膝关节活动度为115°～145°,无屈曲挛缩畸形;膝关节功能采用Rasmussen胫骨平台骨折评分评定疗效:优21例,良12例,可5例,优良率为86.8%。1例患者在术后3个月时发现关节面塌陷(下沉深度为1.5 mm),其余患者至末次随访时未发现关节面塌陷。结论采用钢板内固定联合磷酸钙骨水泥治疗胫骨平台骨折,能够有效阻止关节面复位再丢失,临床疗效和影像学结果满意,术后并发症发生率较低。     

双钢板结合克氏针治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折

目的探讨双钢板结合克氏针治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折的疗效。方法对30例SchatzkerⅤ、Ⅵ型胫骨平台骨折患者行双钢板结合克氏针内固定治疗,术后遵循"早活动晚负重、循序渐进"的原则行膝关节功能锻炼。记录切口愈合情况、骨折愈合情况、膝关节活动范围,采用Rasmussen评分标准评价疗效。结果 28例切口愈合良好; 2例外侧切口出现红肿、少量渗出,经伤口换药及对症处理后愈合。患者均获得随访,时间12～24个月。骨折愈合时间4～7个月。末次随访时,膝关节活动度范围:伸直-3°～0°,屈曲95°～135°;采用Rasmussen评分标准评价疗效:优19例,良8例,可3例。结论双钢板结合克氏针内固定治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折复位满意、固定牢靠,能够早期行膝关节功能锻炼,骨折端愈合良好,可有效地减少并发症。     

3D打印技术在复杂胫骨平台骨折手术中的应用研究

目的 探讨应用3D打印技术辅助手术治疗复杂胫骨平台骨折的临床效果。方法 选取2014年1月至2017年3月我院收治的复杂胫骨平台骨折病人29例,随机分为观察组（15例）及对照组（14例）进行队列分析比较。观察组胫骨平台经Mimics软件处理,3D打印成1∶1骨折模型,将骨折及健侧模型进行镜像对比,设定手术方案;对照组常规参照术前X线片及CT制定修复方案。术后观察并对两组的手术时间、出血量、术后关节塌陷纠正情况、术后12个月膝关节Rasmussen功能评分进行比较。结果 本研究29例病人的随防时间为（12.55±2.46）个月。观察组的手术时间、出血量明显小于对照组,术后关节塌陷纠正情况优于对照组,差异均有统计学意义（t=2.297,P=0.029;t=2.674,P=0.013;t=2.658,P=0.020）;术后12个月两组膝关节Rasmussen评分差异无统计学意义（P＞0.05）;观察组膝关节功能恢复优良率（93.33%）高于对照组（78.57%）。结论 针对复杂胫骨平台骨折,应用3D打印技术制作骨折模型,通过模拟手术操作可以有效缩短手术时间,减少术中出血,纠正关节面塌陷程度。     

关节镜辅助下有限内固定治疗胫骨平台骨折

目的探讨在关节镜辅助下复位有限内固定治疗胫骨平台骨折的手术方法及近期疗效。方法胫骨平台骨折58例,术前X线摄片、MRI扫描及三维CT重建,术中在关节镜辅助下首先治疗合并损伤,然后进行复位空心螺钉和克氏针等固定,最后C型臂X线机透视确认,术后坚持"早锻炼,晚负重"的原则。结果随访8～17个月,术后3～4个月骨折骨性愈合。按Rasmussen评分,54例为优良,4例为可,本组评分为(26±3)分,临床效果满意。结论在治疗SchatzkerⅠ～Ⅴ型胫骨平台骨折时,关节镜辅助下的有限切口结合有限固定手术,能够最大限度恢复关节面的解剖连续性,可同时修复半月板和交叉韧带等复合损伤。     

胫骨平台后髁骨折的治疗

目的:探讨胫骨平台后髁骨折的治疗方法。方法:9例胫骨平台后髁骨折患者,男6例,女3例;年龄24⁵8岁,平均36岁。左侧2例,右侧7例。骨折类型:后外侧髁骨折5例,后内侧髁骨折1例,双髁骨折3例,采用后内和（或）后外侧入路复位内固定治疗。结果:9例均获随访,随访时间6³2个月,平均18·4个月。患膝关节功能评定按Hohl评分标准:优7例,良2例。关节面未见明显塌陷情况。结论:膝关节的后内和（或）外侧入路较前侧入路能更充分暴露后关节间隙及胫骨平台后髁,为骨折的直视复位和植骨内固定提供了良好的操作空间。     

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.