应用股骨近端锁定加压钢板治疗股骨转子下粉碎性骨折

目的探讨应用股骨近端锁定加压钢板治疗股骨转子下粉碎性骨折的手术疗效。方法回顾分析应用股骨近端锁定加压钢板内固定治疗19例股骨转子下粉碎性骨折患者的临床资料,其中男12例,女7例,年龄28～84岁,平均55.2岁。按Seinsheimer分型,Ⅲa型8例,Ⅲb型7例,Ⅳ型3例,Ⅴ型1例。结果随访时间12～18个月,平均14个月。骨折临床愈合时间10～16周,平均13.2周,愈合率100%,平均愈合时间6.6个月（4.5～10个月）,对术后髋关节功能评定采用Sanders标准进行评价,优13例,良5例,差1例,优良率94.7%。结论股骨近端锁定加压钢板治疗股骨转子下粉碎性骨折创伤小,固定可靠,骨折愈合快,关节功能恢复满意,是股骨转子下粉碎性骨折较为理想的治疗方法。     

侧卧位股骨近端髓内钉治疗肥胖患者股骨转子下粉碎性骨折

目的 探讨侧卧位股骨近端髓内钉内固定治疗肥胖患者股骨转子下粉碎性骨折的临床疗效. 方法 回顾性分析2006年1月至2011年1月应用侧卧位股骨近端髓内钉内固定治疗的55例肥胖患者股骨转子下粉碎性骨折临床资料,男43例,女12例;年龄20～74岁,平均45.2岁;体质量指数(BMI):肥胖(BMI为30～35)40例,非常肥胖(BMI＞35)15例.骨折按照Seinsheimer分型:A型18例,ⅢB型23例,Ⅳ型12例,Ⅴ型2例.术后采用Sanders等推荐的创伤性髋关节等级评分评定疗效.结果 47例患者术后获得完整随访,随访时间为12 ～60个月,平均30个月;8例失访.骨折愈合时间为3.9 ～8.7个月,平均4.6个月.术后按Sanders等推荐的创伤性髋关节等级评分标准评定疗效:优23例,良12例,中7例,差5例,优良率为74.5％. 结论 侧卧位髓内钉内固定治疗肥胖患者股骨转子下粉碎性骨折手术操作简单,可减少组织血供的破坏,缩短手术时间,减少术中出血量,有利于骨折愈合.     

改良弹性髓内钉技术治疗儿童股骨转子下骨折

目的:探讨改良弹性髓内钉技术治疗儿童股骨转子下骨折的疗效。方法:自2009年3月至2010年12月采用改良弹性髓内钉技术治疗儿童股骨转子下骨折16例,男12例,女4例;年龄7～15岁,平均9.8岁。骨折类型:稳定型骨折(横断或短斜型)9例,非稳定型骨折(粉碎性骨折或长斜型骨折)7例。对患儿的放射学结果和并发症资料进行回顾性研究,采用Flynn评判标准对术后骨折愈合情况进行评价。结果:16例患儿术后均获得随访,时间11～32个月,平均21个月。无切口感染、骨不连及内固定物失效或断裂。骨折愈合时间8～16周,平均10.1周。骨折愈合按照Flynn评判标准进行评估,优14例,良1例,差1例。结论:使用改良弹性髓内钉技术治疗儿童转子下骨折是一种安全有效的固定方法,有利于患儿早期活动,缩短住院时间和减少并发症。     

加长型PFNA治疗股骨转子下粉碎性骨折的临床研究

[目的]评价采用加长型股骨近端螺旋刀片抗旋髓内钉(proximal femoral nail anti-rotation,PFNA)治疗股骨转子下粉碎性骨折的临床疗效.[方法]2006年6月～2011年6月,本院采用AO/ASIF加长型PFNA治疗股骨转子下粉碎性骨折83例,男57例,女26例；年龄19 ～72岁,平均42.6岁,所有患者均为股骨单侧闭合性骨折,受伤至手术时间间隔为3～7d,平均4.1d.术后第1、2、3、6、9、12个月门诊随访,以后每年至少门诊复查1次.随访时所有患者均拍摄股骨中近段正、侧位X线片.临床疗效评价采用Harris髋关节功能评分标准.[结果]83例患者手术时间45 ～ 95 min,平均65.7 min；术中出血量50 ～150ml,平均86.4 ml,所有患者均为术后4～7d下地扶拐逐渐限量负重行走.83例患者均获得完整随访,随诊4,～36个月,平均18.3个月,所有患者术后未出现感染、下肢静脉血栓形成,未出现螺旋刀片切割股骨头及断钉现象,3例出现髋内翻短缩畸形；无骨折不愈合者,骨折愈合时间为3.3 ～5.7个月,平均3.6个月.按Harris髋功能评分标准:优56例,良24例,中3例,优良率96.39％( 80/83).[结论]加长型PFNA治疗具有微创、固定强度高、生物力学特性好等优点,在治疗股骨转子下粉碎性骨折时骨愈合率高、功能恢复快、并发症少.     

重建交锁髓内钉和动力髋螺钉治疗股骨转子下长节段粉碎骨折的对比研究

[目的]对比分析股骨转子下长节段粉碎性骨折重建交锁髓内钉(重建钉)内固定和动力髋螺钉(DHS)内固定的手术时间、出血量、并发症、下地负重时间、骨折愈合时间及临床疗效,寻求其中比较理想的一种内固定方法.[方法]回顾性分析2001年1月～2006年1月本院手术治疗的股骨转子下长节段粉碎性骨折患者27例,将27例按不同的内固定方法分为2组,其中DHS内固定组(A组)11例,男9例,女2例,平均38.75±6.25岁;重建钉内固定组(B组)16例,男14例,女2例,平均36.80±4.54岁;对2组手术时间、出血量、并发症、下地负重时间、骨折愈合时间及疗效评定方面进行对比分析.[结果]随访12～28个月,平均14.71个月,结果发现股骨转子下长节段粉碎性骨折2种内固定方法在手术时间(t=1.78,P＞0.05)、出血量(t=1.96,P＞0.05)、并发症(Fisher精确概率检验P=0.38)和疗效评定方面(Fisher精确概率检验P=0.50)无显著性差异;在下地负重时间(t=3.01,P＜0.05)和骨折愈合时间(t=2.71,P＜0.05)方面有显著性差异,重建钉较DHS短.[结论]对于股骨转子下长节段粉碎性骨折的治疗,重建交锁髓内钉内固定较动力髋螺钉更为理想.     

经皮加压钢板系统治疗股骨转子间骨折

目的 探讨经皮加压钢板系统(PCCP)治疗股骨转子间骨折的临床疗效。方法 2009年5月至12月采用PCCP治疗17例股骨转子间骨折患者,男6例,女11例;年龄34～ 90岁（平均71.8岁）。骨折根据改良Evan分型：ⅠA型4例,ⅠB型1例,Ⅱ型9例,Ⅲ型3例。受伤至手术时间为2～5d,平均2.5d。观察并记录患者术中出血量、切口长度、术后疼痛程度及术后髋关节功能Harris评分。结果 术中出血量平均为55 mL(30～90 mL);近端切口长2～3 cn,远端切口长3～4 cm;术后疼痛视觉模拟法评分平均为1.5分（1～3分）。17例患者术后获4～10个月（平均7个月）随访。骨折均获愈合,愈合时间为2～3个月（平均2.6个月）。术后髋关节功能Harris评分平均为88.1分（80～93分）;其中优3例,良13例,可1例,优良率为94.1％。均未出现切口感染、深静脉血栓形成、螺钉钢板断裂及髋内翻等并发症。结论 PCCP治疗股骨转子间骨折具有术中出血量少、手术创伤小、骨折固定稳定、术后功能恢复好等优点,是治疗改良Evan Ⅰ～ Ⅱ型股骨转子间骨折较理想的固定方法。     

股骨近端外侧锁定加压钢板和动力髋螺钉治疗老年人股骨转子间骨折临床力学对比

目的 分析对比股骨近端锁定板(Locking proximal femur plates,LPFP)和动力髋螺钉(Dynamic hip screw DHS)固定股骨转子间骨折时的力学特点.方法 本院自2007年12月至2009年1月共收治股骨转子间骨折42例,男27例,女15例.年龄62～90岁,平均72.8岁.骨折按Evans分型,DHS治疗14例:Ⅰ型3例,Ⅱ型8例,Ⅲ型3例;股骨近端锁定板治疗28例:Ⅲ型13例,Ⅳ型15例.术后随访并术后1个月、3个月、6个月X线复查.结果 参照Harris髋关节功能评分标准,DHS组患者优良率88%;股骨近端锁定板组优良率93%.两组数据进行u检验(u＝0.785,P＞0.05 ),结果 DHS组治疗股骨转子间EvanⅠ、Ⅱ型骨折与股骨近端锁定板组治疗股骨转子间EvanⅢ、Ⅳ型骨折疗效,无显著统计学差异.结论 通过力学对比,DHS适于固定股骨转子间EvanⅠ、Ⅱ型骨折,股骨近端锁定板更适于EvanⅢ、Ⅳ型骨折.大转子在"张力带"结构中有着重要作用,应当对其引起足够的重视.     

新一代髓内钉InterTAN在股骨转子间骨折治疗中的应用

目的 探讨新一代髓内钉InterTAN治疗股骨转子间骨折的适应证、手术技巧及临床疗效.方法 2008年12月到2009年12月采用新一代髓内钉InterTAN内固定治疗53例股骨转子间骨折患者,男20例,女33例;平均年龄79.3岁（60～95岁）.骨折根据改良Evan分型：均为顺转子间骨折,其中ⅠA型2例,ⅠB型7例;ⅡA型4例,ⅡB型18例;Ⅲ型22例.记录并对比患者伤前及术后6个月SF36量表评分,对患者术后3个月和6个月的X线片进行评价.结果 所有患者术后获平均8.3个月（6～15个月）随访,期间死亡3例（5.7%）.51例患者3个月内获临床愈合,平均愈合时间为（11.5±0.8）周.1例术后6周出现拉力螺钉切出股骨头,行螺钉位置调整术后12周获骨折愈合.伤前SF36量表评分平均为（106.0±16.1）分,术后6个月平均为（102.3±17.5）分,差异无统计学意义（t=0.176,P=0.247）.61.5%（32/52）的患者（获随访53例,去掉术后14 d死亡1例）SF36量表评分恢复至伤前水平.结论 新一代髓内钉InterTAN固定术可用于治疗粉碎、复杂及合并骨质疏松的股骨转子间骨折;其设计更符合股骨近端生物力学特征,能有效恢复股骨近端稳定性,减少卧床时间,提高生活质量,降低死亡率及并发症.     

动力髋螺钉结合记忆合金弓齿钉治疗股骨粗隆下SeinsheimerⅤ型粉碎性骨折

目的:探讨动力髋螺钉(dynamic hip screw,DHS)结合形状记忆合金弓齿钉内固定治疗股骨粗隆下Sein-sheimerⅤ型粉碎性骨折的临床疗效。方法:2005年6月至2007年1月收治12例股骨粗隆下粉碎性骨折患者,其中男8例,女4例;年龄31～65岁,平均53岁。受伤原因:车祸伤7例,高处坠落伤4例,重物砸伤1例。按Seinsheimer分类均为Ⅴ型。均采用动力髋螺钉结合形状记忆合金弓齿钉内固定治疗。结果:12例患者均获得随访,时间20～38个月,平均28个月。全部病例均获得骨性愈合,平均愈合时间3.3个月(3～4.5个月)。未发生深部感染、下肢深静脉血栓、肺栓塞、骨不连等并发症。按Merled'Aubigne髋关节功能评分为(16.75±1.14)分,其中优4例,良8例。结论:动力髋螺钉结合形状记忆合金弓齿钉治疗股骨粗隆下SeinsheimerⅤ型骨折,复位满意,固定牢靠,是治疗股骨粗隆下骨折可选择的理想治疗方法之一。     

合并冠状面骨折的股骨转子间严重粉碎性骨折外科治疗的临床对照研究

目的:探讨半环式梯形加压钢板及股骨近端解剖型钢板固定治疗合并冠状面骨折的股骨转子间严重粉碎性骨折的疗效及手术特点。方法:1998年1月至2007年3月,57例合并冠状面骨折的股骨转子间严重粉碎性骨折的患者分成两组:采用自行研制的半环式梯形加压钢板固定21例,男11例,女10例,平均年龄41.8岁;采用股骨近端解剖型钢板固定36例,男17例,女19例,平均年龄42.1岁。两组的骨折按照AO分类均为股骨转子间A3型骨折。术后髋关节依据Harris评分标准进行评定。结果:57例获得随访,时间5个月～9年3个月,平均4.8年;骨折愈合时间8～20周,平均12.8周。Harris评分结果显示:解剖钢板组疼痛评分明显高于梯形加压钢板组(P0.05);髋关节功能评分解剖钢板组明显高于梯形加压钢板组(P0.01);畸形及关节活动范围两组比较差异无统计学意义(P0.05)。结论:合并冠状面骨折的股骨转子间严重粉碎性骨折因转子外侧部骨皮质完整性受到破坏,以此为力学支点进行穿钉固定的多种内固定物应用受限制,股骨近端解剖钢板和半环式梯形加压钢板可有效解决这一问题。     

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.