The effects of portal, hepatic arterial and femoral venous administration of prostaglandin E1 (PGE) on portal venous flow (PVF) and hepatic arterial flow HAF were examined before and after 70% hepatectomy in anesthetized dogs. In the hepatectomized condition, portal venous administration of PGE (0.5 microgram/kg/min) caused an increase in PVF without any change in systemic arterial pressure (SAP). HAF was unchanged following the injection. The portal effect of PGE on PVF was dose-dependent, and a reduction in portal venous resistance was seen. However, the same dose of PGE failed to change PVF under intact liver conditions. Hepatic arterial administration of PGE (0.5 microgram/kg/min) brought no significant change in PVF or HAF, with or without hepatectomy. Femoral venous administration of PGE (0.5 micrograms/kg/min) produced an increase in PVF concomitant with a significant decrease in SAP. HAF showed no change after the injection. A decrease in PVR was seen only in the hepatectomized condition. It is concluded that PGE is potent in increasing PVF in the hepatectomized condition, and the portal vasculature is involved as the site of action.

To reduce the doses of intravenous anesthetics (ketamine, diazepam, droperidol, and vecuronium) used in total intravenous anesthesia (TIVA), epidural administration of a ϰ-stimulating opioid, eptazocine, was combined with TIVA in 115 patients. Surgical procedures were uneventful under TIVA plus epidural eptazocine; significant depression of EEG and somatosensory-evoked potentials during anesthesia were observed without delay in recovery. The circulatory response and blood glucose level during and after anesthesia and surgery were stable, and there was no postanesthetic respiratory depression. On the other hand, in 46 patients given TIVA only, hypertension, tachycardia, and elevated blood glucose during and after anesthesia were observed: in 25 (54.3%) patients, a vasodepressor was required, and in 18 (39.1%) patients, nitrous oxide was needed. Therefore, epidural eptazocine may make it possible to use lower doses of anesthesia in TIVA, thus reducing the adverse effects associated with TIVA such as hypertension during surgery, intraoperative awareness, postanesthetic respiratory depression, delayed recovery from anesthesia, and neurological signs after anesthesia. This may be due to the ϰ-stimulating action of epidural eptazocine on the spinal cord and its σ-blocking action, as well as its lack of μ-action on the brain.

Portal venous blood flow (PVF), hepatic arterial blood flow (HAF), and systemic arterial pressure (SAP) were examined after prostaglandin E1 (PGE1) was injected into the vena cava superior (VCS) of liver-transplanted pigs. The injection of PGE1 at 0.2 micrograms/kg/min for 2 min on the day of transplantation and 3 days later produced an increase in PVF without causing any change in HAF or SAP, the response in PVF being dose-dependent. However, no reliable change in PVF, HAF, or SAP was seen when the same dose of PGE1 was administered 7 days after transplantation. Furthermore, no significant difference was noted among the values for PVF and total hepatic blood flow (THF) during the experimented days, although the HAF value had increased markedly 3 days after transplantation. These findings suggest that PGE1 is effective in increasing PVF in the liver transplanted condition; however, the hepatic circulatory improvement attributed to this agent would be limited to the first few days following transplantation.

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