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

Purpose: 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 followi ng aortic cross- clamp and release. Methods: In a randomised double blind controlled trial 24 patients schedule d for elective infrarenal abdominal aortic aneurysm repair were studied in two centres and were assigned to one of two treatment groups, Group I recei ved a dopexamine infusion starting at 0.5 mug . kg(-1). min(-1) increased t o 2 mug . kg(-1). min(-1) maintaining a stable heart rate; Group II receive d a placebo infusion titrated in the same volumes following induction of an esthesia, Measured and derived hemodynamic data, tissue oxygen delivery and extraction and gut permeability were recorded at set time points throughou t the procedure. Results: Dopexamine infusion (0.5 -2 mug . kg(-1)min(-1)) was associated wi th 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 extr action 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 a nd II respectively). Conclusions: Dopexamine infusion (0.5 -2 mug . kg(-1). min(-1)) did not enh ance hemodynamic function and tissue oxygenation values during elective inf rarenal abdominal aortic aneurysm repair.