Impact of dopamine and endothelin-1 antagonism on portal venous blood flow during laparoscopic surgery.
BACKGROUND
Recent data indicate that pneumoperitoneal carbondioxide (CO2) insufflation impairs hepatic macro- and microcirculation. Whether dopamine and endothelin-1 (ET-1) antagonists might restore liver blood during laparoscopic surgery has not yet been investigated.


METHODS
For this study, 30 male WAG/Rij rats were randomized into two groups to obtain pneumoperitoneum with CO2 (n=15) or helium (n = 15). All the animals were implanted with a polyethylene-50 cannula into the right vena jugularis and a Doppler ultrasound flow probe around the portal vein. In each group, the rats were administered dopamine (n = 5); JKC-10, JKC-301, which is a selective endothelin-1 (ET-1) antagonist (n = 5), or sodium chloride as a control (n = 5). Portal blood flow was measured during intraabdominal pressures 2 to 12 mmHg. Data were analyzed using the Kruskal-Wallis h-test.


RESULTS
The application of dopamine and ET-1 antagonists significantly improved portal blood flow over that of the control animals (p <0.05). No significant differences were found between CO2 and helium insufflation (P > 0.05).


CONCLUSIONS
Dopamine and ET-1 antagonism restore portal blood flow during laparoscopic surgery independently of the insufflation gas. Whether improved hepatic perfusion might have beneficial effects on liver function needs further investigation.
Kim
Z-G
ZG
Department of General and Vascular Surgery, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany.
Sanli
E
E
Brinkmann
L
L
Lorenz
M
M
Gutt
C N
CN
D000818:Animals; D001783:Blood Flow Velocity / Q000187:drug effects; D002245:Carbon Dioxide / Q000009:adverse effects / Q000627:therapeutic use; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D004195:Disease Models, Animal; D018492:Dopamine Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D019332:Endothelin-1 / Q000037:antagonists & inhibitors* / Q000494:pharmacology* / Q000627:therapeutic use; D007327:Insufflation / Q000009:adverse effects; D007431:Intraoperative Complications / Q000517:prevention & control; D007511:Ischemia / Q000517:prevention & control; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008099:Liver / Q000098:blood supply / Q000187:drug effects / Q000601:surgery; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects / Q000379:methods; D011169:Portal Vein / Q000187:drug effects* / Q000601:surgery*; D051381:Rats; D011919:Rats, Inbred Strains; D012039:Regional Blood Flow / Q000187:drug effects*; D018608:Ultrasonography, Doppler / Q000379:methods
D018492:Dopamine Antagonists; D019332:Endothelin-1; D002245:Carbon Dioxide