Anaesthesia for abdominal aortic surgery — a review (Part I)

Cunningham, Anthony J.

doi:10.1007/bf03005343

Cited by 18 publications

(7 citation statements)

References 127 publications

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“…The magnitude of the cardiovascular response to AXC is dependent on the actual site of the clamp (25). Following thoracic AXC, 40% increases in SVR and up to 60% increases in proximal MAP have been reported (3). Infra-renal AXC is associated with less pronounced responses and 15-30% increases in proximal MAP have been demonstrated (4,5).…”

Section: Discussionmentioning

confidence: 99%

“…In the circulation proximal to the clamp , AXC is usually associated with increases in arterial blood pressure and systemic vascular resistance and moderate reductions in stroke volume and cardiac output (1)(2)(3)(4). The effects of AXC on pulmonary arterial occlusion pressure and central venous pressure seem to depend on whether ischaemic heart disease is present or not (5).…”

mentioning

confidence: 99%

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Cardiovascular responses to experimental infra‐renal aortic cross‐clamping. Modulating effects of isoflurane, sodium nitroprusside and milrinone

Seeman-Lodding

Biber

Martner

et al. 1996

Acta Anaesthesiol Scand

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The objective that during AXC MAP should not exceed control non-clamp levels was achieveable by ISO, SNP or MIL. The modulating actions of the drugs on MAP during AXC were exerted mainly through reductions in non-clamp levels. This systemic hypotension was associated with decreased CO and SVR during ISO, and with decreased SVR and increased HR during SNP and MIL. Attenuation of the AXC-induced increase in SVR was produced only by 1.4% ISO.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Cardiovascular responses to experimental infra‐renal aortic cross‐clamping. Modulating effects of isoflurane, sodium nitroprusside and milrinone

Seeman-Lodding

Biber

Martner

et al. 1996

Acta Anaesthesiol Scand

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“…Other options for these patients include serial three-monthly observations with abdominal ultrasound or internal iliac ligation with axillobifemoral bypass. 50 Besides CAD, the preoperative evaluation…”

Section: Preoperative Evaluation and Preparationmentioning

confidence: 99%

Anesthesia for Open Abdominal Aortic Aneurysm Repair

Gelzinis

Subramaniam²

2010

Anesthesia and Perioperative Care for Aortic Surgery

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“…Nonetheless, tachycardia associated with dopexamine infusion is a concern in a patient population with a high incidence of overt and covert ischaemic heart disease. 6 Dopexamine hydrochloride is a synthetic dopaminergic (DA-1) and beta-2 adrenoreceptor agonist. As such, it has been reported to be one third as potent as dopamine in stimulating DA-1 receptors but 60 times more potent as a beta-2 adrenoceptor agonist.…”

Section: Group I Group Ii Normal Meanmentioning

confidence: 99%

Dopexamine hydrochloride does not modify hemodynamic response or tissue oxygenation or gut permeability during abdominal aortic surgery

McGinley

Lynch

Hubbard

et al. 2001

Can J Anesth/J Can Anesth

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GENERAL ANESTHESIAPurpose: To assess the effects of intraoperative infusion of dopexamine (a DA-1 and B2 adrenoreceptor agonist) on hemodynamic function, tissue oxygen delivery and consumption, splanchnic perfusion and gut permeability following aortic cross-clamp and release.Methods: In a randomised double blind controlled trial 24 patients scheduled for elective infrarenal abdominal aortic aneurysm repair were studied in two centres and were assigned to one of two treatment groups. Group I received a dopexamine infusion starting at 0.5 µg·kg -1 ·min -1 increased to 2 µg·kg -1 ·min -1 maintaining a stable heart rate; Group II received a placebo infusion titrated in the same volumes following induction of anesthesia. Measured and derived hemodynamic data, tissue oxygen delivery and extraction and gut permeability were recorded at set time points throughout the procedure.Results: Dopexamine infusion (0.5 -2 µg·kg -1 ·min -1 ) was associated with enhanced hemodynamic function (MAP 65 ± 5.5 vs 92 ± 5.7 mm Hg, P =<0.05) only during the period of aortic cross clamping. However, during the most part of infrarenal abdominal aortic surgery, dopexamine did not reduce systemic vascular resistance index, mean arterial pressure nor oxygen extraction compared with the control group. The lactulose/ rhamnose permeation ratio was elevated above normal in both groups (0.22 and 0.29 in groups I and II respectively).Conclusions: Dopexamine infusion (0.5 -2 µg·kg -1 ·min -1 ) did not enhance hemodynamic function and tissue oxygenation values during elective infrarenal abdominal aortic aneurysm repair.Objectif : Évaluer les effets d'une perfusion peropératoire de dopexamine, un agoniste des adrénorécepteurs DA-1 et B2, sur l'hémodynamie, l'apport et la consommation d'oxygène tissulaire, la perfusion splanchnique et la perméabilité intestinale à la suite d'un clampage total de l'aorte et de son retrait. Méthode : Il s'agit d'un essai randomisé, contrôlé et à double insu auprès de 24 patients, provenant de deux centres et répartis en deux groupes, qui ont subi la réparation d'un anévrysme aortique abdominal sous-rénal. Le groupe I a reçu une perfusion de dopexamine amorcée à 0,5 µg·kg -1 ·min -1 , augmentée à 2 µg·kg -1 ·min -1 , maintenant une fréquence cardiaque stable; le groupe II a reçu une perfusion placebo de même volume après l'induction de l'anesthésie. Les données hémodynamiques mesurées et dérivées, l'apport et la consommation d'oxygène tissulaire et la perméabilité intestinale ont été notés à des moments de mesure déterminés au cours de l'intervention.Résultats : La perfusion de dopexamine (0,5 -2µg·kg -1 ·min -1 ) a stimulé la fonction hémodynamique (TAM 65 ± 5,5 vs 92 ± 5,7 mm Hg, P = <0,05) pendant le clampage aortique seulement. Cependant, pendant la majeure partie de l'intervention aortique abdominale sous-rénale, la dopexamine n'a pas réduit l'indice de résistance vasculaire générale, la tension artérielle moyenne ou la consommation d'oxygène, ces données étant comparées avec celles du groupe témoin. Le ratio de diss...

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Anaesthesia for abdominal aortic surgery — a review (Part I)

Cited by 18 publications

References 127 publications

Cardiovascular responses to experimental infra‐renal aortic cross‐clamping. Modulating effects of isoflurane, sodium nitroprusside and milrinone

Cardiovascular responses to experimental infra‐renal aortic cross‐clamping. Modulating effects of isoflurane, sodium nitroprusside and milrinone

Anesthesia for Open Abdominal Aortic Aneurysm Repair

Dopexamine hydrochloride does not modify hemodynamic response or tissue oxygenation or gut permeability during abdominal aortic surgery

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