The effect of dopamine on hepatic blood flow in patients undergoing epidural anesthesia.
We studied the effect of dopamine on hepatic blood flow during epidural anesthesia with the infusion of hydroxyethyl starch (HES). Hepatic blood flow was measured noninvasively via indocyanine green (ICG) clearance (indices: K [ICG disappearance rate] and R15 [15-min ICG retention rate]). Group C (n = 7) received no epidural anesthesia, Group E (n = 14) received epidural anesthesia, and Group E + D (n = 7) received a dopamine infusion (5 microg x kg(-1) x min(-1)) during epidural anesthesia. Epidural blockade extended from a median of T5 (T4-7) to L4 (L3-5) in Group E and from T5 (T4-7) to L4 (L3-S1) in Group E + D. Mean arterial pressure was maintained at preanesthetic levels in Groups E and E + D. K decreased and R15 increased in Group E (P < 0.05). In Groups C and E + D, K decreased and R15 increased slightly, but not significantly. K was smaller and R15 greater in Group E than in Group C (P < 0.05). We conclude that hepatic blood flow is decreased by epidural anesthesia, despite normotension maintained by continuous infusion of HES, but that this decrease in flow is reversed by the addition of a dopamine infusion.
Tanaka
N
N
Department of Anesthesiology, Miyazaki Medical College, Kiyotake, Japan.
Nagata
N
N
Hamakawa
T
T
Takasaki
M
M
D000328:Adult; D000767:Anesthesia, Epidural; D000779:Anesthetics, Local / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects; D004396:Coloring Agents; D004298:Dopamine / Q000627:therapeutic use*; D005260:Female; D005836:Genitalia, Female / Q000601:surgery; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage / Q000627:therapeutic use; D007208:Indocyanine Green; D007262:Infusions, Intravenous; D008102:Liver Circulation / Q000187:drug effects*; D008619:Mepivacaine / Q000008:administration & dosage; D009407:Nerve Block; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000627:therapeutic use
D000779:Anesthetics, Local; D004396:Coloring Agents; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D008619:Mepivacaine; D007208:Indocyanine Green; D004298:Dopamine