乳腺癌术前化疗对罗库溴铵肌松效应的影响

目的 研究乳腺癌术前化疗对罗库溴铵肌松效应的影响.方法 全麻下肌松监测乳腺癌手术患者43例,分为术前化疗组(A组,25例)和未进行化疗组(B组,18例).两组术前均未用对肌松有影响的药物.用加速度仪监测拇内收肌收缩反应,观察罗库溴铵0.6 mg/kg静注后肌松时效的差异.结果 A、B两组起效时间分别为(93±18)S和(96±19)s,差异无统计学意义;A组临床时效长于B组[(49±16)min vs.(37±13)min],A组恢复指数也长于B组[(14.2±3.0)min vs.(10.9±2.5)min](P<0.05).结论 乳腺癌术前化疗对罗库溴铵的临床作用时效和恢复延长.     

术中磁共振成像对持续泵注罗库溴铵肌松效应的影响

目的 观察神经外科手术术中磁共振成像(iMRI)对罗库溴铵肌松效应的影响.方法 采用前瞻、随机、对照研究.择期行开颅手术的患者30例,ASA Ⅰ或Ⅱ级,随机均分为两组:iMRI组(M组)和非iMRI组(C组).采用加速度仪四个成串刺激(TOF)监测肌松.两组采用相同的保温措施.麻醉诱导后给予罗库溴铵0.6 mg/kg,T1为0时静脉泵注罗库溴铵0.3～0.7Mg·kg-1·h-1,维持T1在0～5%.关闭硬脑膜时停止泵注罗库溴铵.记录T1恢复25%、TOF恢复25%、75%、90%的时间,停止泵注罗库溴铵至手术结束时间,罗库溴铵用量等.结果 术中M组患者腋温逐渐升高,而C组逐渐降低.手术时M组和C组腋温分别为(37.00±0.36)℃和(35.53±0.74)℃.M组TOF 25%、TOF 75%、TOF 90%时间显著短于C组(P<0.05或P<0.01).结论 iMRI可使患者体温升高,加快罗库溴铵TOF 25%的恢复,缩短临床及体内作用时间,但对于恢复指数无显著影响.     

氢化泼尼松对全麻女性患者罗库溴铵神经肌肉阻滞效应的影响

目的探讨氢化泼尼松对全麻女性患者罗库溴铵起效时间和恢复时间的影响。方法择期全麻女性患者40例,拟行甲状腺或乳腺手术,年龄18～65岁,ASAⅠ或Ⅱ级,BMI18.5～25kg/m2,随机均分为两组:氢化泼尼松组(H组)和对照组(C组)。H组麻醉诱导前50min给予氢化泼尼松30mg,两组麻醉诱导相似。使用TOF-watch肌松监测仪四个成串刺激模式监测刺激尺神经时TOFr(T4/T1)变化,记录起效时间、TOFr25%及75%的恢复时间(TOF25、TOF75)和TOF25%～75%恢复时间。结果 H组起效时间为(129.30±28.57)s,明显长于C组的(83.55±17.90)s(P<0.05);H组TOF25为(40.95±2.89)min,明显短于C组的(49.55±5.81)min(P<0.05);H组TOF75为(50.65±4.63)min,明显短于C组的(62.50±5.19)min(P<0.05);H组TOF25%～75%恢复时间(9.70±2.83)min,明显短于C组的(12.95±4.65)min(P<0.05)。结论氢化泼尼松能使全麻女性患者罗库溴铵的起效时间延长,而恢复时间缩短。     

七氟醚对罗库溴铵肌松效应的影响

目的 观察七氟醚对罗库溴铵肌松作用的影响.方法 成人全麻手术患者60例随机均分为三组.每组20例.Ⅰ组丙泊酚静脉麻醉,Ⅱ组吸入七氟醚(1 MAC)15 min,Ⅲ组吸入七氟醚(1 MAC)45 min.在麻醉平稳(Ⅱ、Ⅲ组在呼气末七氟醚浓度稳定在1 MAC)后静脉注射罗库溴铵0.6 mg/kg,记录TOFr的变化.结果 Ⅱ、Ⅲ组罗库溴铵的起效时间分别为97.60 s和94.50 s,明显短于Ⅰ组的119.90 s(P<0.05);Ⅱ和Ⅲ组完全肌松时间(T1消失)明显长于Ⅰ组(32.7 min和44,6 min vs.21.3 min)(P<0.05),Ⅲ组明显长于Ⅱ组(P<0.05);TOF的T2～T4出现的时间及TOFr恢复到25%、50%和75%的时间,Ⅱ、Ⅲ组均长于Ⅰ组,且Ⅲ组长于Ⅱ组(P<0.05).结论 持续吸入1 MAC七氟醚能随吸人时间延长而增强罗库溴铵的神经肌肉阻滞效应.     

舒更葡糖钠对胸腹腔镜食管癌根治术患者术后肌松恢复的影响

目的探讨舒更葡糖钠对全麻下胸腹腔镜食管癌根治术患者术后肌松恢复的影响。方法选择全麻下行胸腹腔镜食管癌根治术患者96例,男61例,女35例,年龄18~65岁,ASAⅠ或Ⅱ级。采用随机数字表法将患者分为两组:新斯的明联合阿托品组(C组)和舒更葡糖钠组(S组),每组48例。两组麻醉诱导和术中全麻维持方案相同,使用四个成串刺激(TOF)监测肌松。手术结束后,待肌松监测T2出现时,C组静脉注射新斯的明0.05 mg/kg联合阿托品0.02 mg/kg,S组静脉注射舒更葡糖钠2 mg/kg。记录从给予肌松拮抗药到TOF比值(TOFr)恢复至0.9的时间,从给予肌松拮抗药到拔除气管导管的时间(拔管时间)。计算给予肌松拮抗药后5、15、30 min时肌松残余率。记录术后首次排气、排便时间,记录术后恶心呕吐(PONV)等并发症的发生情况。结果与C组比较,S组TOFr恢复至0.9的时间明显缩短[(2.2±0.9)min vs(16.2±3.4)min,P<0.01],拔管时间明显缩短[(12.3±2.0)min vs(33.0±5.1)min,P<0.01],给予肌松拮抗药后5、15 min时S组肌松残余率明显降低(12%vs 100%、0%vs 65%,P<0.01),S组术后首次排气时间明显缩短[(23.4±2.1)h vs(30.5±3.1)h,P<0.01],PONV发生率明显降低[7例(15%)vs 19例(40%),P<0.05]。两组术后首次排便时间差异无统计学意义。结论舒更葡糖钠用于胸腹腔镜食管癌根治术患者,能更快地逆转罗库溴铵作用下的肌松作用,降低肌松残余发生率,促进患者术后胃肠运动的恢复,减少术后并发症的发生,改善术后肌松恢复质量。     

罗库溴铵和顺式阿曲库铵用于肝部分切除术肌松效应的比较

目的比较罗库溴铵和顺式阿曲库铵用于肝部分切除术的肌松效应。方法择期全麻下行剖腹单纯肝部分切除术患者40例,随机均分为罗库溴铵组(R组)和顺式阿曲库铵组(C组)。全麻肌松药诱导量R组和C组分别为2倍ED95的罗库溴铵0.6mg/kg及顺式阿曲库铵0.1mg/kg,采用TOF监测肌松程度,当TOFr至25%时追加肌松药。观察两组肌松药起效时间、气管插管条件、临床作用时间、术毕恢复指数、气管拔管时间及不良反应。结果 R组起效时间明显快于、临床作用时间及术毕恢复指数明显长于C组(P0.05);两组气管拔管时间差异无统计学意义。当TOFr为0时,R组气管插管条件为优的例数明显多于C组(P0.05)。R组静脉注射痛发生率为16例(80%),明显高于C组的3例(15%)(P0.05)。两组患者围术期均未发生皮肤潮红、BP降低、HR增快及支气管痉挛等不良反应,未观察到拔管后的肌松残余作用。结论与顺式阿曲库铵比较,应用罗库溴铵具有起效快,作用时间长,虽恢复指数略长,但对拔管时间并无影响,同时未有明显的肌松残余作用,可以安全用于肝部分切除术的患者。     

肝硬化病人乌司他丁预处理对罗库溴铵肌松作用的影响

目的观察肝硬化病人乌司他丁预处理对罗库溴铵肌松作用的影响。方法选择30例患有肝硬化的成年手术病人,随机均分为两组:乌司他丁组(Ⅰ组),静注乌司他丁5000U/kg后1min,静脉给予罗库溴铵0.6mg/kg;生理盐水组(Ⅱ组),静脉给予生理盐水0.1ml/kg后1min,静脉给予罗库溴铵0.6mg/kg。另选15例无肝脏疾患的、ASAⅠ～Ⅱ级择期成年手术病人为对照组(Ⅲ组),处理同Ⅱ组。肌松监测仪检测四个成串刺激(TOF)的变化,记录三组注药后罗库溴铵的起效时间(注药到TOFr=0)、TOF无反应时间(T1=0持续时间)、T1最大抑制程度、临床时效(TOFr恢复至25%时间)、T1恢复至75%时间、恢复指数。结果与Ⅱ、Ⅲ组比较,Ⅰ组插管剂量罗库溴铵的起效时间明显延长(P<0.05)。Ⅱ、Ⅲ组罗库溴铵肌松的起效时间相似。与Ⅱ组比较,Ⅰ、Ⅲ组T1恢复25%时间和恢复指数明显缩短(P<0.05)。Ⅰ、Ⅲ组罗库溴铵肌松的恢复时间相似。结论肝硬化病人乌司他丁预处理延长罗库溴铵的起效时间,但缩短罗库溴铵肌松作用时间。     

地氟醚七氟醚对糖尿病患者罗库溴铵肌松效应影响的比较

目的 比较地氟醚和七氟醚对糖尿病患者罗库溴铵肌松效应的影响.方法 择期2型糖尿病腹部手术患者60例,年龄45～64岁,ASA分级Ⅱ级,采用随机数字表法分为3组,每组20例:地氟醚组(DD组)、七氟醚组(SD组)和异丙酚组(PD组).静脉注射咪达唑仑、异丙酚和芬太尼行麻醉诱导后启动肌松监测,3组分别用异丙酚、地氟醚和七氟醚维持麻醉.记录肌松维持时间和恢复指数.于静脉注射罗库溴铵后10、20、30、40、50、60、70、80、90、100、110、120 min时记录T1/T0比值及T4/T1比值[四个成串刺激(train-of-four stimulation, TOF)比值].结果 DD组和SD组患者罗库溴铵的维持时间[(61±17),(60±18) min]、恢复指数[(36±12),(35±10) min]之间差异无统计学意义(P＞0.05),且均大于PD组(P＜0.05).DD组、SD组患者静脉注射罗库溴铵后60～120 min时T1/T0比值和TOF比值差异无统计学意义(P＞0.05),且均大于PD组(P＜0.05).结论 地氟醚和七氟醚对糖尿病患者罗库溴铵肌松效应的影响差异无统计学意义.     

比较维库溴铵在青年和中年女性患者全麻中的肌松效应

目的 观察并比较维库溴铵在青年和中年女性患者全麻中肌松效应的影响. 方法 将40例按美国麻醉医师协会（ASA）分级标准定为Ⅰ～Ⅱ级的乳腺包块手术女性患者分为青年组（18岁～44岁）和中年组（45岁～59岁）,每组20例.麻醉诱导期间给予2 ED95 0.1 mg/kg维库溴铵,用TOF-Watch加速度仪进行肌肉松弛监测,采用四个成串刺激（train of four,TOF）方式监测拇内收肌的收缩反应.观察起效时间、时效、体内作用时间、恢复指数、TOF比率恢复到25％的时间. 结果 青年组肌松起效时间、体内作用时间及TOF恢复到25％的时间均明显短于中年组[（156±33）、（186±44）s、（67±29）、（77±20）、（48±14）、（60±16） min] （P＜0.05）.两组时效[（37±10）、（43±11）min]、恢复指数[（21±17）、（22±13） min]差异无统计学意义（P＞0.05）.结论 与中年女性患者比较,青年女性患者对维库溴铵较敏感,起效快,体内作用时间短,但对肌松恢复过程无影响.     

年龄对罗库溴铵靶控输注时效的影响

目的 探讨靶控输注(TCI)罗库溴铵时年龄对其药效学的影响.方法 选择ASA Ⅰ或Ⅱ级、无神经肌肉疾患、接受丙泊酚-NzO/O2-芬太尼复合麻醉的患者30例,根据年龄分为老年组和青壮年组,每组15例.在静脉注入罗库溴铵0.6 mg/kg后用加速度仪采用四个成串刺激(TOF)方式监测拇内收肌的收缩反应.待T1恢复至10%时开始TCI罗库溴铵,靶控血浆浓度为2μg/ml.记录神经肌肉阻滞的最大阻滞时间及起效时间、恢复时间,并记录罗库溴铵的用药量.结果 老年组的平均输注速率为(7.6±0.9)μg·kg-1·min-1,青壮年组的平均输注速率为(8.2±0.8)/μg·kg-1·min-1.单次注入罗库溴铵0.6 mg/kg后的起效时间,两组间差异无统计学意义.青壮年组的肌松恢复过程明显快于老年组,表现为单次注药后老年组的无反应期明显长于青壮年组(P<0.01);停止TCI后T1恢复到25%、50%和75%的时间及恢复指数,老年组都明显长于青壮年组(P<0.01).但老年组罗库溴铵的平均用药量明显少于青壮年组(P<0.01).两组术中肌松均维持平稳.结论 罗库溴铵采用TCI在老年患者用药量虽然相应减少,但其恢复过程仍较青壮年组延长.     

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.