椎弓根螺钉内固定结合椎体成形术治疗老年胸腰椎爆裂性骨折

目的:探讨椎弓根内螺钉固定结合椎体成形术治疗老年胸腰椎爆裂性骨折的可行性并评估其疗效。方法:采用短节段椎弓根螺钉内固定结合经椎弓根伤椎内注射骨水泥治疗60岁以上老年胸腰椎爆裂性骨折患者23例,术后观察骨折椎体前后缘压缩率变化、Cobb角改善情况及并发症。结果:术后随访12￣40个月(平均24.2个月)。骨折椎体前后缘均恢复满意,术前椎体前、后缘压缩率分别为(52.76±5.07)%和(18.12±2.29)%,术后椎体前后缘压缩率分别为(8.09±0.83)%和(0.99±0.22)%,术后与术前比较差异均有统计学意义(P<0.01);矢状位Cobb角由术前平均17.0°矫正至5.1°,平均矫正10.9°,无术后并发症,平均下地时间为18d。10例脊髓神经损伤患者,术后按美国脊髓损伤协会(ASIA)标准恢复1级及以上,无1例脊髓神经损伤加重者。椎体高度无明显丢失,无椎间隙塌陷,无内固定断裂或弯曲、松动。结论:后路椎弓根螺钉内固定结合椎体成形术,能同时恢复椎体高度及强度,重建脊柱的稳定性,使患者早期下地活动,可减少内固定应力过大造成的断钉、椎体高度丢失等并发症,是治疗老年胸腰椎爆裂性骨折的有效方法。     

经伤椎椎弓根螺钉固定治疗胸腰椎爆裂骨折28例临床体会

目的探讨经伤椎椎弓根固定在胸腰椎爆裂骨折中的疗效。方法对28例胸腰椎爆裂性骨折给予伤椎及上下邻椎钉棒系统椎弓根螺钉内固定,并行椎板切除减压,横突间植骨融合。结果经过14～32个月,平均18.4个月随访,术前伤椎椎体压缩率(56.3±12.1)%,Cobb角(16.8±7.9)°;术后12周伤椎椎体压缩率(16.5±7.9)%,Cobb角(7.4±6.1)°。手术前后伤椎椎体压缩率和Cobb角差异均有统计学意义(P<0.05)。结论经伤椎椎弓根固定治疗胸腰椎爆裂骨折具有即时复位程度高、术后椎体高度和后凸矫正丢失少的优点。     

RF-Ⅲ(AF)脊柱复位固定器手术治疗胸腰椎骨折22例报告

目的探讨AF脊柱复位固定器在胸腰椎骨折治疗中的使用价值。方法用RF-Ⅲ(AF)脊柱复位固定器手术治疗胸腰椎压缩性骨折无椎管压迫者7例;爆裂性骨折椎管压迫12例,chance骨折2例,骨折伴脱位1例;前者仅做AF复位固定韧带修补术,后者增用椎板减压骨块复位椎体外植骨融合。结果术后随访3~20个月。X线片示椎体高度完全恢复17例,恢复90%以上4例,无明显恢复1例。Cobb角由术前平均29(°12°~41)°矫正到术后平均约4(°0°~9)°;8例椎管压迫明显者术后CT复查椎管容积明显增大。Frankel分类A级病人感觉平面下降或部分恢复,运动,排便功能无改善;B-D级病人均有1~2级恢复。断棒1例,螺钉松动2例。椎体前缘高度丢失3例;Cobb角增加5°-8°。结论RF-Ⅲ(AF)系统脊柱复位固定器在脊柱纵轴上有撑开,压缩(前柱撑开)性能,是一种较理想的脊柱三维复位固定器材。     

双开窗减压RF内固定治疗胸腰段椎体爆裂骨折

目的　总结治疗胸腰椎爆裂骨折的经验。方法　采用双开窗减压RF内固定治疗胸腰椎爆裂骨折 2 0例。结果　经 12～ 2 4个月随访 ,椎体平均前后高度由术前的 5 0 6%和 75 4%恢复为术后的 91 2 %和 96 3%。Cobb角由术前平均 17 8°恢复为术后平均 1°。结论　该方法复位、固定可靠 ,创伤小 ,可保留未损伤节段功能 ,同时保留了后柱的稳定性。     

保留后韧带结构的AF系统治疗胸腰段爆裂骨折

目的　探讨一种治疗胸腰段爆裂骨折伴截瘫的方法 ,使术后脊柱稳定性较好。方法　用AF系统治疗胸腰段爆裂骨折 5 4例 ,手术时保留脊柱后韧带结构。统计术前术后伤椎前后缘高度、Cobb角资料。结果　术后伤椎前缘高度恢复至 ( 95 1± 8 5 ) % ,后缘高度恢复至 ( 98 5± 7 2 ) % ,Cobb角恢复至 ( 4 8± 2 5 )°。各项指标与术前比较差异有显著性 (P <0 0 1)。术后随访 0 5～ 3 5年 ,神经功能按Frankel评定 :46例提高 1～ 3级。结论　后韧带结构为坚韧有弹性的骨 -韧带条 ,在维护脊柱稳定的过程中 ,有着无法替代的价值。行椎管减压术应保留后韧带结构 ,术后脊柱稳定性较好 ,拆除内固定后脊柱不易滑移后凸 ,疗效优于单纯AF系统内固定手术     

拱形椎弓根螺钉钢板内固定治疗腰椎爆裂型骨折69例

目的　探讨腰椎爆裂骨折的治疗方法。方法　采用Steffee钢板折弯成 2 0°～ 30°拱形 (弧形 ) ,利用拱形钢板与脊柱后凸畸形之间凸面的失偶现象产生折顶过伸复位与内固定 ,同时采取腰椎板两侧开窗减压和“夹心式”加压植骨。结果　完成 6 9例 ,随访 1～ 7年 ,平均 3 3年 ,术前椎体前缘高度平均 5 7 2 % ,术后 2周平均 91 4% ,手术一年后平均 85 7% ;术前椎体后缘高度平均 73 8% ,术后 2周平均 97 2 % ,手术一年后平均 88 1%。Cobb角术前上腰椎 (L1-3)平均 2 3° ,术后平均 6°;下腰椎 (L4 ,5)术前平均 2° ,术后腰椎生理前凸平均恢复为 18°。神经损伤在下腰椎骨折的病例中恢复较好。结论　拱形椎弓根钢板对脊椎后柱产生过伸折顶复位的力学支点 ,使三柱产生均匀的前凸撑开 ,降低了前柱和中柱对螺钉的压缩负荷。开窗减压减少腰椎后部结构的损伤 ,夹心式加压植骨提高了脊柱融合的质量。术后短期内椎体平均高度矫正满意 ,钢板疲劳变形与内固定松动是导致术后远期椎体高度丢失的主要原因。     

对AF系统整复压缩爆裂骨折椎体高度及椎管横截面的观测

目的 :量化评价AF系统恢复胸腰段压缩爆裂椎体高度椎管截面积的效果。方法 :测量AF系统治疗的 72例胸腰段压缩爆裂骨折术前后影像。统计椎体前后缘高度、Cobb角、椎管截面积资料。结果 :术后伤椎前缘高度恢复至 ( 96.5± 2 .3 ) %后缘高度恢复至 ( 98.2± 0 .9) % ,Cobb角恢复至 ( 5 .4± 1.5 )° ,椎管截面积恢复至 ( 97.2± 2 .1% ) ,各项指标与术前比较有非常显著性差异 (P <0 .0 0 1)。术后随访 0 .5～ 3 .5年 ,神经功能按Frankel评定 :60例提高 1～ 3级。结论 :AF系统能恢复或基本恢复胸腰段压缩爆裂骨折椎体的前后缘高度、Cobb角、椎管容积 ,为脊髓神经功能的恢复提供一个良好的环境。是治疗脊柱胸腰段压缩爆裂骨折较好的内固定器。     

胸腰椎爆裂型骨折的外科治疗

目的探讨胸、腰椎爆裂型骨折的外科治疗策略。方法回顾性分析1998年1月~2004年5月手术治疗的胸、腰椎爆裂型骨折患者59例,男42例,女17例,年龄19~58岁,平均38岁。受伤节段为T11~L3。侧位X线片示骨折椎体楔形变。骨折椎体高度压缩程度为1/4~3/4(在侧位X线片上骨折椎体前、后缘高度与相邻上下节段椎体前、后缘高度的平均值之比)。其中后路手术43例,前路手术16例。结果全部病例随访12个月~3年,平均21个月,椎体前、后缘高度分别由术前平均37.5%(12.0%~46.0%)和79.0%(31.0%~87.0%)恢复到术后92.5%(90.0%~100%)和97.4%(94.5%~99.8%),Cobb角由术前平均23°(13°~39°)恢复到术后平均2.3°(1°~6°),脊髓损伤患者按Frankel分级,除5例A级无明显改善外,其余病例均有明显改善,平均改善1级以上。结论胸、腰椎爆裂型骨折手术治疗的疗效是肯定的,手术方式的选择依术者所在医院的条件、医师手术技巧及患者的病情而定。     

重建后柱部分结构加AF系统治疗胸腰段骨折并截瘫

目的探讨一种治疗胸腰段爆裂骨折伴截瘫的方法,使术后脊柱稳定性较好。方法用AF系统治疗胸腰段爆裂骨折59例,手术时重建脊柱后柱部分结构。统计术前、术后2周和术后1a伤椎前后缘高度、Cobb角资料。结果术后伤椎前缘高度恢复至95.1%±8.5%,后缘高度恢复至98.5%±7.2%,Cobb角恢复到4.8°±2.5°。各项指标与术前比较有显著性差异(P<0.01)。术后随访1~3.5a,各项指标与术后2周比较无显著性差异(见表1,P>0.05),神经功能按Frankel评定,44例提高1~3级。结论后柱结构为坚韧有弹性的骨韧带条,在维护脊柱稳定的过程中,有着无法代替的作用。行椎管减压术应尽量保留后柱结构,术后脊柱稳定性较好,疗效优于单纯AF系统内固定手术。     

后外侧减压植骨融合内固定治疗胸腰段爆裂骨折临床观察

目的观察后外侧减压植骨融合内固定治疗胸腰段爆裂骨折的临床疗效。方法采用后外侧减压植骨融合内固定治疗胸腰段爆裂骨折患者26例,术前检查示伤椎压缩20%～65%,平均压缩45%,后突角23°～35°,平均28.5°。65%患者合并神经系统损伤,所有患者均采用后外侧减压植骨融合内固定治疗,术后随访1 a(观察椎体高度、Cobb角变化情况)。结果平均手术时间为(2.1±0.4)h,平均透视时间(16±5)min,平均出血(480±40)mL。所有病例术后无神经功能恶化现象,术前AMS评分为(42.5±11.4)分,术后1 a AMS评分为(78.5±10.2)分,术后1 a AMS评分与术前相比有明显提高,差异有统计学意义(P<0.05)。术后1 a脊柱后凸Cobb’s角、椎体前缘、椎体后缘高度压缩率与术前比较,差异均有统计学意义(P均<0.05)。结论后外侧减压植骨融合内固定治疗胸腰段爆裂骨折是一种有效方法,具有创伤小、操作简单、并发症少且能够维持脊柱稳定性,脊髓神经功能恢复好的优点。     

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 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.     

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.