Role of dopamine in renal dysfunction during laparoscopic surgery.
BACKGROUND
Sympathetic vascular insult and hemodynamic changes represent the most reliable explanation of renal impairment resulting from acute intraabdominal pressure. We evaluated the effects of low-dose dopamine administration during a long-lasting surgical laparoscopic procedure.


METHODS
For this study 40, patients submitted to a colorectal laparoscopic procedure with 15 mmHg of intraabdominal pressure were randomly allocated to two groups: 20 receiving 2 mg/kg/min of dopamine and 20 receiving the same perfusion of saline. Hemodynamic parameters, renal function, urinary output, and creatinine clearance, were studied.


RESULTS
The hemodynamic parameters were similar in both groups. The urinary output decreased during the intraoperative period only the saline group (p = 0.4). Then 2 h postoperatively, it increased in both groups, and no statistically significant differences were found between the groups. The creatinine clearance decreased in both groups during the intraoperative time, but it was worse in the saline group (-28 +/- 120 vs -194 +/- 106; p = 0.022). During the postoperative period, both groups showed improvement, but in control group the values remained lower than at baseline (p = 0.04), and significantly lower than in the dopamine group (230 +/- 337 vs 100 +/- 192; p = 0.012).


CONCLUSIONS
An intrabdominal pressure of 15 mmHg induces a time-limited renal dysfunction, and low doses of dopamine could prevent this undesirable effect.
Pérez
J
J
Anesthesiology Department, Hospital Clinic of Barcelona, University of Barcelona, Villaroel 170, Barcelona, 08036, Spain. yoyajordi@yahoo.com
Taurá
P
P
Rueda
J
J
Balust
J
J
Anglada
T
T
Beltran
J
J
Lacy
A M
AM
Garcia-Valdecasas
J C
JC
D015179:Colorectal Neoplasms / Q000601:surgery; D004298:Dopamine / Q000008:administration & dosage / Q000502:physiology* / Q000627:therapeutic use; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007262:Infusions, Intravenous; D007431:Intraoperative Complications / Q000517:prevention & control; D007668:Kidney / Q000098:blood supply / Q000187:drug effects / Q000503:physiopathology; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D008875:Middle Aged; D011027:Pneumoperitoneum / Q000503:physiopathology / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D014554:Urination / Q000187:drug effects
D004298:Dopamine