胸肩峰动脉肩胛冈骨瓣移位术的应用解剖

目的　为以胸肩峰动脉为蒂肩胛冈骨瓣移位术提供解剖学依据。　方法　在 40侧成人尸体标本上 ,观察了胸肩峰动脉走行、分支及分布。　结果　胸肩峰动脉主要分支中的肩峰支长度( 5 1± 0 1)cm、外径 ( 1 2± 0 2 )mm ,其三角肌支沿三角肌胸大肌间沟走行 ,除分支到三角肌和胸大肌外 ,与旋肱前动脉有恒定吻合 ,其外径 ( 1 9± 0 2 )mm ,发出点至三角肌、胸大肌入肌点长分别为 ( 4 8±0 5 )cm和 ( 3 2± 0 4)cm。　结论　可设计以胸肩峰动脉肩峰支为蒂 ,或在胸肩峰动脉肩峰支和三角肌支分支前结扎动脉干 ,以三角肌支 肩峰支为蒂的肩胛冈外侧段骨瓣移位以修复肱骨近端。     

以外踝前血管为蒂胫骨远端前外侧骨膜瓣移位术的应用解剖

目的　为外踝前血管胫骨远端前外侧骨膜瓣移位术提供解剖学依据。　方法　30 侧经动脉灌注红色乳胶的成年下肢标本,观测外踝前动脉的起源、走行、骨膜支及与腓动脉穿支降支的吻合关系。　结果　外踝前动脉有1~2支,起点在外踝尖上(1. 1±0 .4)cm,起始外径(1 .6±0 .4)cm,沿途发1~3支,外径为(0 .4~0 .8)mm的骨膜支分布胫骨远端外侧。腓动脉穿支起点在外踝尖上(5 .6±0. 5 cm),降支循外踝的前外侧下行,沿途向两侧发出 2~6 支外径为 0 .5~1. 0 mm的骨膜支滋养胫骨远端前外侧和外踝。两者吻合部位在外踝尖上(1. 7±0. 6)cm,距外踝前动脉起点外侧(2. 5±0 .6)cm。吻合后动脉经趾短伸肌后部,沿腓骨短肌腱的前缘前行,终支与跗外侧动脉、跟外侧动脉相吻合。　结论　以外踝前血管为蒂的胫骨远端前外侧骨膜瓣,可移位用于修复距骨颈骨折和距骨体缺血性坏死。     

前臂正中浅静脉腕部分支的解剖观察及在断指再植中的临床应用

目的　观察前臂正中浅静脉腕部分支的解剖特点 ,并总结其在复杂断指再植中的应用经验。方法　观察 10 0名 2 0 0侧健康成人前臂正中浅静脉腕部分支的出现率。对 2 8例 3 4侧成人前臂正中浅静脉腕部分支进行显微解剖观察 ,并测量其口径。临床为 2 5例伴指动脉缺损的断指 ,取患侧前臂正中浅静脉腕部分支桥接指动脉后进行再植。结果　前臂正中浅静脉腕部分支主干的出现率为 98% ,细支的出现率为 90 %。分支主干口径 0 .5 6± 0 .0 5mm( x±s,下同 ) ,细支口径 0 .3 6± 0 .0 5mm。 2 5例断指再植后 2 4h内发生动脉危象 5例 ,2例手术切除动脉栓塞段后重新吻合 ,3例保守治疗后均成活。 2 0例断指术后顺利成活。结论　前臂正中浅静脉腕部分支的主干和细支解剖位置恒定 ,口径合适 ,适用于各平面断指再植中行血管移植。     

比目鱼肌内侧半为蒂胫骨骨膜瓣逆行移位的应用解剖

目的　为临床一次性修复胫骨中下段骨折、骨不连或骨缺损合并软组织缺损提供一种行之有效的新方法。　方法　在 35侧经动脉内灌注红色乳胶的下肢标本上 ,解剖观测比目鱼肌内侧半及其胫骨内侧附着处肌骨膜瓣的形态和血供特点 ,设计以比目鱼肌内侧半为蒂胫骨骨膜瓣逆行移位术。　结果　比目鱼肌内侧半血供主要来源于胫后动脉节段性供应 ,平均每侧 6支 ;胫骨内侧此肌附着处长 (8.9± 0 .7) cm,中部宽 (1.0± 0 .4) cm;肌骨膜瓣血供来源于胫后动脉肌骨膜支、胫后动脉肌间隙支和比目鱼肌内侧半直接肌骨膜支 ;可切取骨膜瓣面积 9.0 cm× 3.0 cm,逆行移位最低旋转点位于内踝突出点上 (9.7± 2 .4) cm。　结论　该术式简便实用 ,经临床应用 4例取得满意疗效。     

膝上外侧血管蒂阔筋膜瓣移位修复膝关节软骨缺损的应用解剖

目的　为膝上外侧血管蒂阔筋膜瓣移位修复膝关节软骨缺损提供解剖学依据。方法在 30侧经动脉灌注红色乳胶的成人下肢标本上 ,解剖观测膝上外侧动脉 (LSGA)的起始、走行、分支、分布及吻合等情况。结果　膝上外侧动脉于腓骨头最突出点近侧垂直距离 (6 .1± 1 .1 )cm处起自月国动脉 ,起始动脉外径 (1 .7± 0 .3)mm。起始后沿股骨后外侧向前外侧上行 ,分为升、降支 ,升降支共发 2～ 5支穿支进入阔筋膜 ,穿支血管外径 0 .2～ 0 .8mm ,这些阔筋膜穿支与旋股外侧动脉降支及膝网相互吻合。结论　可设计以膝上外侧血管为蒂的阔筋膜瓣移位术修复膝关节软骨缺损。     

桡动脉肌间隙支桡骨中下段骨膜瓣的应用解剖学研究

目的　为带血管桡骨中下段骨膜瓣移位术提供解剖学依据。方法　在 40侧经动脉灌注红色乳胶的成人上肢标本 ,解剖观测了桡骨中下段骨膜血管的来源、分支、分布及其吻合。结果　桡骨中下段骨膜血管来自桡动脉肌间隙支和直接骨膜支 ,前者干长 (4.8± 1 .0 )cm ,外径 (1 .2± 0 .2 )mm ;后者干长 (1 .9± 0 .6)cm ,外径 (0 .9± 0 .2 )mm。二者沿旋前圆肌上、下缘紧贴骨膜走行 ,形成骨膜动脉网分布于桡骨体部中下段 ,并直接吻合构成皮支穿肌间隙和深筋膜 ,沿前臂桡侧缘与前臂桡侧其他皮支相吻合。结论　以桡动脉肌间隙支为蒂的桡骨中下段骨膜瓣 ,可用于修复尺、桡骨骨不连     

阴股沟皮瓣应用解剖学研究

目的明确阴股沟皮瓣的解剖学基础.方法对10具(20侧)成年女尸阴股沟区皮肤进行解剖学研究.结果阴股沟皮瓣存在多重血液供应;其中,闭孔动脉前皮支分布于皮瓣中部,浅出点距会阴正中线(3.0±0.5)cm,距阴道口前缘(1.7±0.4)cm距耻骨下支外侧缘(0.6±0.2)cm,管径(0.8±0.1)mm;阴唇后动脉主要供应大阴唇,并恒定地以本干的形式在大阴唇皮下与阴部外浅动脉形成血管吻合,在阴道口后缘前后各1.5cm的范围内,发出2、3支阴唇后动脉外侧支,外径为(0.7±0.3)mm,分布于阴股沟皮瓣后部;阴部外浅动脉斜形穿过皮瓣上端走向大阴唇,沿途发出柳枝状血管分支分布于皮瓣上端.结论阴股沟皮瓣阴道再造所利用的血管是阴唇后动脉外侧支,而非阴唇后动脉主干;由于闭孔动脉前皮支浅出点位置较高而且固定,以之为蒂形成的皮瓣不适用于阴道再造,而适合于会阴部较小皮肤缺损的修复.     

健侧胸外侧神经移位修复臂丛损伤的应用解剖

目的　为臂丛神经根性损伤提供有效的可供使用的动力神经源。　方法　在 46侧成人尸体标本上 ,观测了胸外侧神经起始部位、走行、分支、长度、支配部位 ,在放大镜下对其向近端进行无损伤分离 ,追踪其神经纤维来源并进行测量。　结果　 46侧中有 43侧起源于上、中干前股 ,3侧起源于上干前股 ;42侧胸外侧神经发出 3支 ,其中 2支分别支配胸大肌上、中部 ,另 1支为交通支 ;胸大肌上部支主要来源于 C5、6 ,其无损伤分离长度 (2 .3± 0 .5 ) cm,中部支及交通支来源于 C7,其无损伤分离长度(1.5± 0 .4) cm,3支长度分别为 (3.7± 0 .5 ) cm、(6 .1± 1.1) cm、(3.2± 0 .5 ) cm,胸外侧神经颈部至对侧肩胛上、上干前股及肌皮神经的长度分别为 (11.6± 1.2 ) cm、(12 .5± 1.3) cm、(15 .9± 2 .1) cm。　结论　健侧胸外侧神经移位可用于修复臂丛损伤。     

胸廓内动脉瘤误诊为纵隔肿瘤1例报告

<正>胸廓内动脉(internal thoracic artery,ITA)由锁骨下动脉发出,沿胸骨外侧缘约1. 5 cm经第1～7肋软骨后面向下行走,沿途分支分布于胸前壁、乳房、心包和膈。胸廓内动脉瘤是外周动脉瘤中的少见类型,多数因外伤形成假性动脉瘤,根据其分支所在部位不同,影像学检查易误诊为心包、纵隔、肺部     

比目鱼肌内侧半为蒂胫骨骨膜瓣逆行转位的解剖及临床研究

目的　为临床上治疗胫骨中下段骨不连、骨缺损或新鲜粉碎骨折合并软组织缺损提供一种简单而有效的新方法。方法　在 3 5侧经动脉内灌注红色乳胶的下肢标本上 ,解剖观测比目鱼肌的形态和血供特点 ,设计了比目鱼肌内侧半为蒂胫骨骨膜瓣逆行转位的手术方式。结果　比目鱼肌内侧半肌瓣血供主要来源于胫后动脉节段性供应 ,平均每侧 6支 ,胫骨内侧缘肌附着处长( 8.87± 0 .66)cm ,中分宽 ( 1.0 4± 0 .3 7)cm ,可取骨膜瓣面积 ( 9.0± 3 .0 )cm2 ,逆行转位最低旋转点位于内踝突出点上 ( 9.70± 2 .43 )cm。经临床应用 2 0例 ,疗效满意。结论　本术式可一期修复胫骨中下段骨不连、骨缺损或新鲜粉碎骨折并软组织缺损。手术操作简便实用。     

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.