This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (7) Citing Articles via Google Scholar Google Scholar Articles by Agustí, M. Articles by Taurà, P. Search for Related Content PubMed PubMed Citation Articles by Agustí, M. Articles by Taurà, P. Related Collections Cardiovascular

---

CARDIOVASCULAR ANESTHESIA

The Effects of Vasoactive Drugs on Hepatic Blood Flow Changes Induced by CO₂ Laparoscopy: An Animal Study

Mercè Agustí, MD^*, J. Ignasi Elizalde, MD, Ramon Adàlia, MD^*, Graciela Martínez-Pallí, MD^*, Juan C. García-Valdecasas, MD, Josep M. Piqué, MD, and Pilar Taurà, MD^*

Departments of *Anesthesia (URSC), Gastroenterology, and Digestive Surgery (IMD), Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain

Address correspondence and reprint requests to Pilar Taurà, MD, Anesthesiology Department, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain. Address e-mail to 29272mal{at}comb.es

Laparoscopic surgery is associated with systemic and splanchnic hemodynamic alterations. Recent data suggest that small-dose dobutamine may attenuate the reduction in splanchnic blood flow associated with increments in intraabdominal pressure. We conducted this study to analyze the effects of dopamine and dobutamine on the hepatic circulation in this setting. Twenty-one pigs were anesthetized and mechanically ventilated. A flow-directed pulmonary artery and carotid artery catheters were inserted. Perivascular flowprobes were placed around the main hepatic artery and the portal vein. CO₂ was insufflated into the peritoneal cavity to reach an intraabdominal pressure of 15 mm Hg. After 60 min, animals received dopamine (5 µg · kg^-1 · min^-1; n = 8), dobutamine (5 µg · kg^-1 · min^-1; n = 8), or saline (n = 5) for 30 min. Pneumoperitoneum induced significant increases in heart rate, mean arterial pressure, and systemic vascular resistance, with decreases in cardiac output and hepatic artery and portal vein blood flows. Dobutamine infusion, in contrast to dopamine, corrected, at least in part, cardiac output, systemic vascular resistance, and hepatic artery blood flow alterations, but neither drug restored total hepatic blood flow.

IMPLICATIONS: Hepatic blood flow decreases during laparoscopic surgery. A small-dose infusion of neither dobutamine nor dopamine corrects the total hepatic blood flow impairment, but the former is able to restore the hepatic arterial blood supply in an animal model mimicking this condition.

This article has been cited by other articles:

				S. M. Jakob Splanchnic Blood Flow in Low-Flow States Anesth. Analg., April 1, 2003; 96(4): 1129 - 1138. [Abstract] [Full Text] [PDF]