Key result
Dopamine infusion at 5 µg/kg/min reversed the significant decrease in hepatic blood flow caused by epidural anesthesia (P<0.05 for epidural vs control).
Why the study?
Does dopamine infusion improve hepatic blood flow in patients undergoing epidural anesthesia?
Does dopamine infusion improve hepatic blood flow in patients undergoing epidural anesthesia?
p-value: p=<0.05
Dopamine infusion reverses the decrease in hepatic blood flow caused by epidural anesthesia.
May support hepatic perfusion during epidural anesthesia; hypothesis-generating and requires randomized confirmation before practice change.
We studied the effect of dopamine on hepatic blood flow during epidural anesthesia with the infusion of hydroxyethyl starch (HES).Hepatic blood flow was measured noninvasively via indocyanine green (ICG) clearance (indices: K [ICG disappearance rate] and R15 [15-min ICG retention rate]). Group C (n = 7) received no epidural anesthesia, Group E (n = 14) received epidural anesthesia, and Group E + D (n = 7) received a dopamine infusion (5 micro g [center dot] kg-1 [center dot] min-1) during epidural anesthesia. Epidural blockade extended from a median of T5 (T4-7) to L4 (L3-5) in Group E and from T5 (T4-7) to L4 (L3-S1) in Group E + D. Mean arterial pressure was maintained at preanesthetic levels in Groups E and E + D. K decreased and R15 increased in Group E (P < 0.05). In Groups C and E + D, K decreased and R15 increased slightly, but not significantly. K was smaller and R15 greater in Group E than in Group C (P < 0.05). We conclude that hepatic blood flow is decreased by epidural anesthesia, despite normotension maintained by continuous infusion of HES, but that this decrease in flow is reversed by the addition of a dopamine infusion. (Anesth Analg 1997;85:286-90)
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Tanaka et al. (1997) studied Patients undergoing epidural anesthesia (n=28). Dopamine vs. Epidural anesthesia without dopamine and no epidural anesthesia was evaluated on Hepatic blood flow (ICG disappearance rate [K] and 15-min ICG retention rate [R15]) (p=<0.05). Dopamine infusion at 5 µg/kg/min reversed the significant decrease in hepatic blood flow caused by epidural anesthesia (P<0.05 for epidural vs control).
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