小剂量氯胺酮与芬太尼用于烧伤患者休克期镇痛效果观察

目的探讨烧伤患者休克期小剂量氯胺酮、芬太尼联合自控镇痛(PCA)效果。方法将60例烧伤患者随机分为传统镇痛组(CAT组),氯胺酮镇痛组(PCIKA组),芬太尼镇痛组(PCIFA组)和氯胺酮、芬太尼联合镇痛组(PCIKFA组),每组15例。CAT组注射盐酸哌替啶50 mg加异丙嗪25 mg,PCIKA组用氯胺酮20 mg/ml加氟哌利多50μg/ml,PCIFA组用芬太尼10μg/ml加氟哌利多50μg/ml,PCIKFA组用氯胺酮10 mg/ml加芬太尼5μg/ml加氟哌利多50μg/ml,3组均采用9500型PCA泵进行静脉PCA。参数设置均为负荷量1.5 ml,PCA量1 ml,锁定时间30 min,持续输注量1.5 ml/h,连续48 h。结果PCIKA组、PCIFA组和PCIKFA组镇痛后1、4、8、24、48h疼痛视觉模拟评分均显著低于镇痛前及CAT组(均P<0.01),而PCIKA组、PCIFA组和PCIKFA组间差异无显著性意义(均P>0.05);镇痛后各组MAP均有不同程度上升,其中PCIKA组最为明显,HR均有不同程度减缓,其中PCIFA组较为显著和稳定,RR变化不大;PCIFA组注射负荷量后BP轻度升高;PCIFA组出现尿潴留2例,嗜睡3例。结论烧伤患者休克期采用小剂量氯胺酮、芬太尼联合静脉PCA镇痛效果好,不良反应少,利于患者平稳渡过休克期。     

小剂量氯胺酮与芬太尼用于烧伤患者休克期镇痛效果观察

目的探讨烧伤患者休克期小剂量氯胺酮、芬太尼联合自控镇痛（PCA）效果。方法将60例烧伤患者随机分为传统镇痛组（CAT组），氯胺酮镇痛组（PCIKA组）。芬太尼镇痛组（PCIFA组）和氯胺酮、芬太尼联合镇痛组（PCIKFA组）。每组15例。CAT组注射盐酸哌替啶50mg加异丙嗪25mg．PCIKA组用氯胺酮20mg／ml加氟哌利多50μg／ml，PCIFA组用芬太尼10μg／ml加氟哌利多50μg／ml．PCIKFA组用氯胺酮10mg／ml加芬太尼5μg／ml加氟哌利多50μg／ml，3组均采用9500型PCA泵进行静脉PCA。参数设置均为负荷量1．5ml，PCA量1ml，锁定时间30min，持续输注量1．5ml／h．连续48h。结果PCIKA组、PCIFA组和PCIKFA组镇痛后1、4、8、24、48h疼痛视觉模拟评分均显著低于镇痛前及CAT组（均P〈0．01），而PCIKA组、PCIFA组和PCIKFA组闯差异无显著性意义（均P〉0．05）；镇痛后各组MAP均有不同程度上升，其中PCIKA组最为明显，HR均有不同程度减缓，其中PCIFA组较为显著和稳定。RR变化不大；PCIFA组注射负荷量后BP轻度升高；PCIFA组出现尿潴留2例，嗜睡3例。结论烧伤患者休克期采用小剂量氯胺酮、芬太尼联合静脉PCA镇痛效果好，不良反应少，利于患者平稳渡过休克期。     

东莨菪碱-曲马多-芬太尼复合液用于剖宫产术后镇痛

目的观察静脉东莨菪碱配伍曲马多与芬太尼在剖宫产术后镇痛的临床效果及不良反应。方法ASAⅠ~Ⅱ级行剖宫产术病人60例,随机分为东莨菪碱组(S组)和氟哌利多组(D组),每组30例。S组,东莨菪碱0·3mg 曲马多500mg 芬太尼0·5mg;D组,氟哌利多2·5mg 曲马多500mg 芬太尼0·5mg。均以生理盐水配置100ml药袋,静脉给予负荷剂量4ml后连接镇痛泵进行病人自控镇痛(PCA)。术后24、48h行视觉模拟评分(VAS)和镇静评分,并对用药总量、PCA量及不良反应发生情况进行观察比较。结果两组VAS差异无显著意义。D组术后24h用药总量、PCA量和镇静评分均大于术后48h,D组术后24h镇静评分比S组高(P<0·05),不良反应发生率D组明显高于S组。结论东莨菪碱配伍曲马多及芬太尼应用于剖宫产术后镇痛安全有效,不良反应发生率明显低于氟哌利多。     

氟比洛芬酯复合芬太尼用于食管癌术后静脉自控镇痛的临床观察

目的 观察氟比洛芬酯用于食管癌术后静脉自控镇痛(PCIA)的效果和安全性.方法 ASA Ⅰ或Ⅱ级食管癌根治术患者60例,随机均分为三组,术后PCIA芬太尼1.0 mg、氟哌利多2.5mg组(A组);术后PCIA芬太尼0.5 mg、氟比洛芬酯100 mg、氟哌利多2.5 mg组(B组);麻醉前静注氟比洛芬酯50 mg,术后PCIA芬太尼0.5 mg、氟比洛芬酯50 mg、氟哌利多2.5 mg组(C组),镇痛药均用生理盐水稀释至100 ml.记录术后1、2、4、8、12、24,36、48 h的镇痛评分(VAS)、Ramsay镇静评分、PCIA按压次数及不良反应.结果 术后PCIA按压次数与各时点的VAS三组间差异均无统计学意义.B、C组Ramsay镇静评分及恶心、呕吐发生率低于A组(P＜0.05).结论 氟比洛芬酯复合芬太尼用于食管癌根治术术后静脉自控镇痛的效果良好,且能减少芬太尼用量,同时降低不良反应的发生.     

曲乃多和芬太尼用于硬膜外自控镇痛的比较

目的:观察曲乃多和芬太尼用于术后病人硬膜外自控镇痛的效果比较。方法:41例ASAⅠ~Ⅱ级的术后病人随机分为曲乃多组(T组)16例和芬太尼组(F组)25例,所有病人的麻醉为连续硬膜外麻醉,术后接PCEA,T组配方0.2％布比卡因+曲乃多2mg／ml+氟派利多5mg／100ml,F组配方0.2％布比卡因+芬太尼2μg/ml+氟哌利多5mg／100ml,两组PCA量为2ml／h,锁定时间15min,Bolus0.5ml,术后24h和48h观察疼痛评分(VRS)和并发症。结果:曲乃多组和芬太尼组病人镇痛效果相似,无显著性差异,曲乃多组发生恶心1例,下肢麻木1例;芬太尼组发生嗜睡1例,尿潴留1例。结论:PCEA曲乃多用于术后镇痛可提供满意的镇痛效果,不良反应少。     

三种不同浓度的氯诺昔康和吗啡用于静脉镇痛的比较

目的　探讨氯诺昔康在病人自控静脉镇痛 (PCIA)的临床应用。方法　选择骨科手术病人 12 0例 ,随机分成四组 ,每组 30例。L1组 ,0 0 2 4 %氯诺昔康 +0 0 1%氟哌利多 ;L2 组 ,0 0 32 %氯诺昔康 +0 0 1%氟哌利多 ;L3 组 ,0 0 4 0 %氯诺昔康 +0 0 1%氟哌利多 ;M组 ,0 0 5 %吗啡+0 0 1%氟哌利多。应用PCA泵LCP给药模式设置 :总量 15 0ml,负荷量 5ml,背景输注 2ml/h ,PCA 1ml,锁定时间 10min。手术后感觉疼痛明显时 (VAS 5 0mm左右 )启动PCA泵。观察PCIA开始、2、4、8、12、16、2 4、36、4 8h各时间点的镇痛效果和不良反应。结果　镇痛效果L1组较M组差 ,L2组与M组相当 ,L3 组优于M组 (P <0 0 5 )。L1、L2 、L3 组间不良反应无显著性差异 ,仅个别出现轻微的恶心呕吐反应 ,且明显少于M组 (P <0 0 1)。结论　 0 0 4 %的氯诺昔康为合适镇痛浓度 ,可安全有效地用于骨科手术术后PCIA的镇痛治疗     

不同浓度罗比卡因术后硬膜外镇痛效果的观察

目的 比较三种不同浓度罗比卡因伍用芬太尼及氟哌利多用于术后硬膜外镇痛效果。方法 60例择期下肢手术病人,随机分为0.25％罗比卡因组(Ⅰ组)、0.20％罗比卡因组(Ⅱ组)和0.15％罗比卡因组(Ⅲ组),均复合芬太尼(5μg／ml)和氟哌利多(0.025mg／ml),硬膜外自控镇痛(PCEA),速率2ml／h。以VAS评分比较三组术后PCEA的镇痛效果,Bromage评分评定运动阻滞情况。结果 术后6、12、24和48h VAS评分,Ⅲ组显著高于Ⅰ、Ⅱ组;Bromage评分Ⅰ组显著高于Ⅱ、Ⅲ组。无明显不良反应。结论 0.20％罗比卡因复合芬太尼和氟哌利多对下肢手术病人术后镇痛效果确切,适合临床应用。     

几种小儿术后镇痛方法的比较

目的探讨适合小儿术后镇痛的理想方案。方法3698例患儿分成静脉镇痛三组和硬膜外镇痛组,静脉镇痛Ⅰ组1752例,芬太尼5μg.kg-1.d-1和氟哌利多50μg.kg-1.d-1逐日减量法,Ⅱ组828例,芬太尼5～7μg.kg-1.d-1和氟哌利多15～20μg.kg-1.d-1,Ⅲ组850例,芬太尼5～7μg.kg-1.d-1、格拉司琼50μg.kg-1.d-1和地塞米松2.5～5mg/d。硬膜外镇痛组268例,芬太尼7μg.kg-1.d-1、布比卡因3μg.kg-1.d-1和氟哌利多30μg.kg-1.d-1逐日减量。结果各组间镇痛效果差异无显著意义。Ⅱ组恶心呕吐发生率稍高于Ⅰ组和Ⅲ组(P<0.05)。Ⅰ组的锥体外系征发生率明显高于其他各组(P<0.01)。结论静脉镇痛较适宜小儿术后镇痛。芬太尼5～7μg.kg-1.d-1复合氟哌利多15～20μg.kg-1.d-1或格拉司琼50μg.kg-1.d-1、地塞米松2.5～5mg/d更适合小儿。     

小剂量氯胺酮复合芬太尼术后静脉镇痛

目的　比较小剂量氯胺酮联合芬太尼与单纯芬太尼术后静脉镇痛的临床效应。方法选择行上腹部手术后患者 12 0例 ,随机均分为三组 ,每组 4 0例 ,以一次性静脉镇痛泵 (2ml/h)分别行静脉术后镇痛。F组 :单纯芬太尼镇痛 ,0 4 μg·kg-1·h-1芬太尼 +5mg氟哌利多。KF1组 :氯胺酮联合芬太尼镇痛 ,0 2 μg·kg-1·h-1芬太尼 +40 μg·kg-1·h-1氯胺酮 +5mg氟哌利多。KF2组 :氯胺酮联合芬太尼镇痛 ,0 2 μg·kg-1·h-1芬太尼 +80 μg·kg-1·h-1氯胺酮 +5mg氟哌利多。各组镇痛泵中药物均用医用盐水稀释至 10 0ml。观察各组患者镇痛 4 8小时内的静息镇痛评分 (VAS方法 )、恶心呕吐、皮肤瘙痒、尿潴留和幻觉的发生情况。结果　三组患者的静息镇痛评分在 12小时内KF1组和KF2组明显低于F组 (P <0 0 5 ) ,而在 12小时后没有明显差别 (P >0 0 5 ) ;恶心呕吐、皮肤瘙痒和尿潴留发生率KF1组和KF2组显著低于F组 (P <0 0 1)。KF1组和KF2组之间在静息镇痛评分和并发症发生方面没有明显差别。三组中均无幻觉发生。结论　小剂量氯胺酮用于术后静脉镇痛可明显减少芬太尼的剂量 ,使恶心呕吐、皮肤瘙痒和尿潴留发生率降低 ,镇痛效果明显优于单纯芬太尼术后静脉镇痛     

静脉与硬膜外泵注曲马多病人自控镇痛的比较

目的　比较术后静脉和经硬膜外应用曲马多病人自控镇痛 (PCA)的临床效果和安全性。方法　 5 2例胸部和上腹部手术病人随机分为静脉注射曲马多病人自控镇痛 (PCIA)组和经硬膜外曲马多病人自控镇痛 (PCEA)组 ,每组 2 6例。两组曲马多负荷量为 1mg/kg ,PCA药物配方均为曲马多 60 0mg +氟哌利多 5mg + 0 9%氯化钠至 10 0ml,持续给药注速 2ml/h ,单次PCA剂量 0 5ml,锁定时间 15分钟。术后定时进行镇痛、镇静评分 ,2 4小时曲马多用量 ,患者满意度及不良反应的观察比较。结果　PCIA组 2 4小时用药量、按键次数及术后视觉模似评分 (VAS)均明显低于PCEA组 (P<0 0 5 )。两组镇静评分低且无明显差异。患者对术后镇痛总体满意程度良好至优秀均在 84 6%以上 ,不良反应发生率两组间无显著性差异。结论　曲马多用于术后镇痛安全有效。但曲马多PCIA镇痛效果明显优于曲马多PCEA ,且用药量少。     

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.