The effects of fenoldopam on coronary conduit blood flow after coronary artery bypass graft surgery.
OBJECTIVE
To quantify the effects of fenoldopam, 0.1 microg/kg/min, on left internal mammary artery (LIMA) and saphenous vein blood flow after coronary anastomosis.


METHODS
Prospective, randomized, double-blind, placebo-controlled trial.


METHODS
University teaching hospital, single institution.


METHODS
Thirty-one American Society of Anesthesiologists III patients undergoing elective coronary revascularization.


METHODS
A perivascular ultrasonic flow probe (Linton Instrumentation, Norfolk, UK) was placed around the LIMA and saphenous vein graft after coronary anastomosis.


RESULTS
Immediately before and at 5-minute intervals for 15 minutes after starting the infusion, blood flow was measured in the LIMA and one saphenous vein graft using a transit time ultrasonic flow probe. Heart rate, blood pressure, and central venous pressure were documented at these time points. Administration of fenoldopam, 0.1 microg/kg/min, did not alter heart rate or blood pressure. A small, nonsignificant increase in LIMA blood flow occurred during the 15-minute study period (30 +/- 12 to 35 +/- 10 mL/min) in patients who received fenoldopam. No significant changes occurred in the placebo group.


CONCLUSIONS
The findings indicate that fenoldopam, 0.1 microg/kg/min, did not influence coronary conduit blood flow to a clinically significant extent. The small increase in LIMA blood flow may be of greater importance in high-risk patients or in the prevention of coronary arterial spasm.
Department of Anesthesia, Cork University Hospital, Wilton, Ireland.
M
M
Halpenny
S
S
Lakshmi
A
A
O'Donnell
S
S
O'Callaghan-Enright
D
D
O'Connell
G
G
Shorten
D000368:Aged; D000758:Anesthesia; D001794:Blood Pressure / Q000187:drug effects; D001026:Coronary Artery Bypass; D003326:Coronary Circulation / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D018818:Fenoldopam / Q000494:pharmacology*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D012501:Saphenous Vein / Q000637:transplantation; D014665:Vasodilator Agents / Q000494:pharmacology*
D014665:Vasodilator Agents; D018818:Fenoldopam