Effects of low-dose dopexamine on splanchnic oxygenation during major abdominal surgery.
OBJECTIVE
To study the influence of low-dose dopexamine on splanchnic oxygenation during major abdominal surgery.


METHODS
Prospective, randomized, placebo-controlled study.


METHODS
University hospital.


METHODS
Eighteen adult patients undergoing elective major abdominal surgery.


METHODS
The patients received either dopexamine at 1 microg/kg/min (group A, n = 9) or 0.90% saline as control (group B, n = 9).


RESULTS
To assess the splanchnic oxygenation, intestinal tissue PO2 (PtissO2) and gastric intramucosal Pco2 (PmucCO2) were measured, and the PCO2 gap (PmucCO2 - PaCO2) was calculated at baseline (T1) and after an infusion period of 60 mins (T2). There was no difference between the groups in the global oxygen transport parameters. Low-dose dopexamine increases PtissO2 on the serosal side of the small bowel (deltaPtissO2, 17+/-24 mm Hg in group A vs. -5+/-10 in group B). The changes in PtissO2 at the serosal side of the colon after dopexamine demonstrated a nonsignificant increase (deltaPtissO2, 7+/-11 mm Hg in group A vs. -11+/-23 mm Hg in group B). In both groups, the Pco2 gap (group A, 6+/-7 mm Hg [T1] and 5+/-6 mm Hg [T2], vs. group B, 9+/-10 mm Hg [T1] and 12+/-10 mm Hg [T2]) remained unchanged compared with the baseline.


CONCLUSIONS
It is concluded that low-dose dopexamine improves PtissO2 at the serosal side of the gut, preferably at the small bowel. However, low-dose dopexamine did not improve gastric PmucCO2.
Müller
M
M
Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig-University, Giessen, Germany.
Boldt
J
J
Schindler
E
E
Sticher
J
J
Kelm
C
C
Roth
S
S
Hempelmann
G
G
D000005:Abdomen / Q000601:surgery*; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D013505:Digestive System Surgical Procedures; D004298:Dopamine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D007413:Intestinal Mucosa / Q000098:blood supply / Q000187:drug effects / Q000378:metabolism; D007432:Intraoperative Period; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects*; D011446:Prospective Studies; D013152:Splanchnic Circulation / Q000187:drug effects; D013154:Spleen / Q000098:blood supply / Q000378:metabolism*
D000318:Adrenergic beta-Agonists; C046318:dopexamine; D004298:Dopamine