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Anesth Analg 1990; 71:9-15
© 1990 International Anesthesia Research Society
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Intestinal Hemodynamics During Laparotomy

Effects of Thoracic Epidural Anesthesia and Dopamine in Humans

Johan Lundberg, MD, Dag Lundberg, MD, Lars Norgren, MD, Else Ribbe, MD, Johan Thörne, MD, and Olof Werner, MD

Received from the Departments of Anesthesiology and Surgery, University Hospital, Lund, Sweden.

Abstract

The effects of thoracic epidural anesthesia (TEA) and dopamine infusion (4 µg·kg–1·min–1) on superior mesenteric artery blood flow (SMABF), the mesenteric arteriovenous oxygen difference (AVDo2) and the mesenteric venous lactate concentration were studied in nine patients before abdominal aortic reconstruction. Thoracic epidural anesthesia reduced SMABF, as measured by electromagnetic flowmetry, to 77% ± 8% (mean ± SEM) of control (P < 0.05), and mean arterial pressure to 46% ± 4% of control (P < 0.01). The mesenteric AVDo2 increased from 27 ± 3 to 39 ± 6 mL/L (P < 0.05) and superior mesenteric venous lactate from 1.03 ± 0.11 to 1.60 ± 0.38 mmol/kg (P < 0.05); systemic AVDo2 and lactate did not change. Dopamine had no significant effect on SMABF and mean arterial pressure before TEA. However, dopamine increased SMABF during TEA (from 77% ± 8% to 137% ± 21% of control; P < 0.01), returned mesenteric AVDo2 to 27 ±3 mL/L (P < 0.05), and elevated mean arterial pressure to 62% ± 4% of control (P < 0.05). It is concluded that the decrease in perfusion pressure during TEA reduces SMABF with resultant evidence of intestinal reductive metabolism. The intestinal blood flow during TEA zoos improved by dopamine.

Key Words: ANESTHETIC TECHNIQUES EPIDURAL—mesenteric blood flow. • GASTROINTESTINAL TRACT, BLOOD FLOW—epidural anesthesia.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 1990 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1990 by the International Anesthesia Research Society.