全髋关节置换术治疗成人先天性髋关节发育不良

目的探讨成人先天性髋关节发育不良（developmental dysplasia hip,DDH）髋臼假体的选择和手术方法。方法全髋关节置换术治疗成人先天性髋关节发育不良24例26个髋;年龄41～68岁,平均52岁。按照Perner分型,其中Ⅰ度10髋应用普通髋臼假体置换,Ⅱ度9髋选用螺旋臼假体,Ⅲ度5髋及度Ⅳ2髋选用小号髋臼假体,真臼部位安置髋臼假体,均为生物型固定,无结构性植骨。结果随访0．5～3．5年,假体与骨床结合牢固,患髋关节疼痛消失,关节功能基本正常,Harris评分平均86分。结论全髋关节置换术是治疗成人先天性髋关节发育不良的有效方法,针对髋臼病变程度的不同分别采用不同类型髋臼假体置换,配合术中的正确操作能简化手术,减少并发症,提高疗效。     

先天性髋臼发育不良继发骨性关节炎的外科治疗

目的 探讨Zweymuller 型人工全髋关节假体置换治疗先天性髋臼发育不良继发髋关节骨性关节炎的有效性。方法 应用Zweymuller型人工全髋关节假体,对29例32个先天性髋臼发育不良继发髋关节骨性关节炎患者行全髋关节置换（THR）。患者全部为女性,单侧26例,双侧3例。Perner分型度17例,19个髋,Ⅱ度7例,7个,Ⅲ度4例,5个髋,Ⅳ度1例,1个髋。平均随访27．5个月,术前Harris评分最高59分,最低25分,平均44．5分.结果所有患者髋关节疼痛完全消失,关节活动度增加,Harris评分最高97分,最低63分,平均85分。结论 特殊设计的Zweymuller型人工全髋关节假体置换初期稳定,手术不需大块植骨和骨水泥,初期随访效果满意。     

先天性髋关节脱位的全髋关节置换术

目的了解先天性髋关节脱位患者行全髋关节置换术后的中远期疗效。方法先天性髋关节脱位患者行全髋关节置换术32例36髋,随访28例31髋,随访时间平均9.5年(3.5~18年)。脱位分类:低位脱位或半脱位15髋,中位脱位11髋,高位脱位5髋。固定方法:髋臼侧,10髋为骨水泥固定,21髋为非骨水泥固定;股骨侧,12髋为骨水泥固定,19髋为非骨水泥固定。结果1例术中发生小转子劈裂,1例术后发生下肢静脉炎,3例两侧肢体不等长2cm以上,1例发生股动脉栓塞。4髋发生假体松动,1髋为大转子不愈合而松动,1髋为单纯假体柄松动,2髋为假体柄和髋臼假体均发生松动;其余27髋Harris评分为85分(术前48分)。结论先天性髋关节脱位的全髋关节置换术,手术相对比较复杂,并发症较多,手术中特别需要考虑两侧肢体的长度、外展肌的平衡、软组织的松解、髋臼骨缺损的处理及假体的选择。     

短颈直柄型股骨假体治疗高位脱位型髋关节发育不良的临床应用

[目的]探讨高位脱位型髋关节发育不良继发骨关节炎的患者,应用短颈直柄型股骨假体进行人工全髋置换的临床体会。[方法]2002年6月～2007年10月,对11例(12髋)高位脱位型髋关节发育不良继发骨关节炎的患者,应用短颈直柄型股骨假体实施人工全髋关节置换术。所有患者均为女性,平均年龄51(41～68)岁。手术采用髋关节后外侧入路,髋臼重建于真正的髋臼窝,根据宿主骨对臼杯的包容情况予以结构性自体植骨;股骨侧应用短颈直柄型假体,骨水泥固定。术中进行广泛的软组织松解。[结果]本组病例患髋旋转中心较术前平均下降4.5(3.8～4.8)cm,患肢平均延长3.9(3.6～4.3)cm。术后平均随访36(10～66`)个月,所有结构性植骨均获得愈合,患髋未出现假体松动,股骨假体的骨-水泥界面及假体-水泥界面均未见透亮线。术后均未出现坐骨神经、股神经麻痹。Harris评分由术前的平均41.8分提高到术后的平均86.2分。[结论]对于术前计划髋关节旋转中心下移不超过5cm的高位脱位型髋关节发育不良继发骨关节炎患者,应用短颈直柄型股骨假体进行人工全髋置换,避免了股骨截骨短缩和大转子截骨,近期效果满意。     

髋关节骨性关节炎及髋臼发育不良对髋关节表面置换术中髋臼安装角度的影响

[目的]研究全髋关节表面置换术中,单纯骨性关节炎及髋关节发育不良对髋臼安装角度的影响及两组病例疗效比较。[方法]自2006～2009年,本科共实施全髋表面关节置换术20例23髋,病因包括单纯骨性关节炎10髋及髋关节发育不良13髋。手术假体均采用金属对金属大直径表面置换假体,股骨侧骨水泥固定,髋臼侧生物型固定。[结果]所有患者均获得近期随访(6个月～3年),随访包括临床评估和放射学评估。两组患者术前术后Harris评分均无明显统计学差异。无一发生术后脱位、股骨颈骨折等并发症。其中单纯骨性关节炎患者术后臼杯外展角25.6°～56.0°(平均43.9°±9.9°),平均髋臼覆盖率达95.8%。髋臼发育不良患者术后臼杯外展角22.4°～69.3°(平均46.8°±12.9°),髋臼覆盖率达84.3%。[结论]金属对金属大直径表面置换假体在治疗单纯骨性关节炎及髋关节发育不良早期临床疗效并无明显统计学差异。但是髋关节发育不良患者行髋关节表面置换术中,髋臼假体外展角离散度要明显高于单纯骨性关节炎组,其髋臼杯假体外展角度控制要难于单纯骨性关节炎。     

人工全髋置换术治疗先天性髋关节发育不良

目的探索全髋关节置换术治疗先天性髋关节发育不良的经验及疗效。方法13例（15髋）先天性髋关节发育不良继发骨性关节炎行全髋关节置换术。随访11例12髋，平均随访时间2.6a，按Crowe分类，其中Ⅰ型6例7髋，Ⅱ型3例髋，Ⅲ型2例2髋，Ⅳ型2例3髋。其中髋臼侧用骨水泥型假体5例，非骨水泥型10例，股骨侧骨水泥型4例，非骨水泥型11例。结果 1例髋小转子劈裂骨折，1例术后深静脉栓塞，随访期未见有感染，异位骨化，假体松动，坐骨神经损伤等并发症。术前Harris评分平均47例，术后2.6a为88分。结论 全髋关节置换术是治疗成份先天性髋关节脱位继发骨性关节炎的有效方法，但手术难度较大，手术中应特别考虑外展肌的平衡，软组织的松解，髋臼骨缺损的处理以及双侧肢体的长度。     

Zweymǔller系统在女性Crowe-Ⅲ、Ⅳ型髋臼发育不良全髋置换术中的应用

[目的]探讨Zweymfiller系统在全髋关节置换术治疗矮小的女性Crowe-Ⅲ、Ⅳ型髋臼发育不良的应用。[方法]2004年1月-2006年12月，作者采用Zweymǔller系统对12例13髋因髋臼发育不良的女性患者行全髋关节置换。年龄28-62岁，平均51岁；身高1．48-1．55m。按Crowe分型，Ⅲ型8例9髋，Ⅳ型4例4髋。术前下肢短缩3-5cm，均存在严重的髋关节疼痛和功能障碍，Harris评分35-64分，平均40分。采用软组织彻底松解、原位髋臼、股骨不截骨的方法全髋关节置换。[结果]术后下肢延长2-5cm。随访12-36个月，平均24个月。经临床和x线片证实，除1例关节脱位外，无股骨干骨折、股神经、坐骨神经损伤及假体松动等并发症。术后Harris评分60-95分，与术前相比有显著差异（P〈0．01）。[结论]对于身材矮小的女性Crowe-Ⅲ、Ⅳ型髋臼发育不良患者，用Zwcyimǔller系统进行全髋关节置换，可以避免髋臼植骨重建，降低手术难度，提高手术效果。     

结构性植骨全髋关节置换在成人高位先天性髋关节脱位中的应用

[目的]探讨结构性植骨全髋关节置换治疗成人高位先天性髋关节脱位的临床疗效。[方法]2003年8月～2006年10月,采用结构性植骨全髋置换治疗成人高位先髋脱位22例,29髋。男10例,女12例。左13例,右16例,年龄平均34.6岁(23～42岁)。临床症状主要为患髋疼痛、不稳定和跛行。术前Harris评分平均为46.8分,双下肢长度差异平均为3.8cm,股骨头脱位高度平均为3.9cm,髋关节平均活动度:屈曲66.5°,外展23.8°,外旋20.4°,内旋5.3°。术中臼杯均安装于真臼处,自体股骨头结构性植骨使臼杯完全覆盖,充分软组织松解后髋关节复位。髋臼侧选用骨水泥假体18髋、小髋臼生物型假体5髋和普通生物型髋臼6髋;股骨侧选用生物型假体10髋、普通骨水泥假体13髋、窄直柄水泥假体柄4髋和长柄骨水泥假体柄2髋。观察手术时间、出血量、关节活动度、双下肢长度差异、并发症等并进行Harris关节功能评分。[结果]本组平均手术时间95min(70～135min),出血400ml(300～650ml);伤口均一期愈合,无1例感染;术后1周X线片示假体位置良好,人工髋臼外展角平均为48.6°,前倾角平均13.2°。本组22例均获随访,随访时间平均17.6个月(10～47个月),Harris评分平均89.2分(72～93分);髋关节平均活动度:屈曲115.3°,外展44.6°,外旋49.5°,内旋26.8°。双下肢长度差异平均1.2cm,2例术后股神经麻痹,术后4个月内恢复。随访期间未见明显植骨块吸收、假体松动和脱位。[结论]结构性植骨全髋关节置换是治疗成人高位先天性髋关节脱位的一种有效方法,很大程度地改善了患者的症状、功能和外形。结构性植骨可提供良好的髋臼覆盖,恢复髋关节旋转中心高度并可保留骨盆骨量。脱位高度小于4cm经软组织充分松解后能下拉复位,不会造成股神经及坐骨神经永久性麻痹。     

成人先天性髋臼发育不良全髋置换术中髋臼重建

目的探讨全髋关节置换治疗成人先天性髋臼发育不良术中髋臼的重建方法。方法对24例32髋成人先天性髋臼发育不良继发骨性关节炎患者进行了全髋关节置换术,21髋行自体股骨头及髂骨移植重建髋臼,11髋单纯行髋臼加深重建髋臼。术后以Harris评分、放射学改变、步态、肢体长度、Trendelenburg征评定治疗效果。结果所有患者均获得随访,时间6个月~5年。Harris评分由术前平均48.2分恢复到术后平均86.4分,X线片显示,自体股骨头及髂骨移植重建髋臼病例所有移植骨块均愈合良好。旋转中心平均下降55mm(37~69 mm)。29髋疼痛消失,3髋术后有轻微疼痛。1例术后Trendelenburg征持续阳性。结论根据术前评估,选择合适的髋臼重建方法进行全髋关节置换对成人先天性髋臼发育不良可获得较好疗效。     

髋臼重建及股骨转子下短缩截骨全髋关节置换治疗Crowe Ⅳ型髋关节发育不良

 目的 探讨髋臼重建及股骨转子下短缩截骨全髋关节置换治疗Crowe Ⅳ型髋关节发育不良的临床疗效。方法 2003年9月至2012年9月收治Crowe Ⅳ型髋关节发育不良患者21例(24髋),男3例,女18例;年龄28~71岁,平均(54±10)岁。采用髋臼重建,股骨转子下横行短缩截骨,股骨近端非骨水泥假体全髋关节置换术。髋臼成形后联合自体结构性骨移植修复骨缺损,生物型假体或钛网骨水泥重建髋臼。陶瓷-聚乙烯股骨头臼界面17例(20髋),金属-聚乙烯4例(4髋)。股骨截骨端自体骨移植18例(21髋),异体骨移植原位钢丝捆扎3例(3髋)。术后采用Harris髋关节评分系统评估髋关节功能。结果 3例失访。随访18例(21髋),随访时间0.5~9年,平均3.5年。Harris髋关节评分从术前(47.9±9.1)分提高至术后6个月(88.4±3.5)分。术后髋关节疼痛明显改善,肢体活动度增加,步态接近正常。1例术后并发坐骨神经麻痹,无伤口感染病例。术后6个月X线片均显示髋臼假体骨性覆盖、假体及植骨床压配较好,无髋臼假体松动及植骨块明显吸收,截骨端骨愈合良好。结论 髋臼重建及股骨转子下短缩截骨全髋关节置换适用于Crowe Ⅳ型髋关节发育不良,尤其是高龄髋关节高脱位患者。操作相对简单,能够改善肢体不等长,可避免一次性过度肢体延长导致的坐骨神经损伤。     

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 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.     

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.     

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.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

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.