THE EFFECT OF DOPAMINE ON HEPATIC BLOOD-FLOW IN PATIENTS UNDERGOING EPIDURAL-ANESTHESIA

We studied the effect of dopamine on hepatic blood flow during epidura l anesthesia with the infusion of hydroxyethyl starch (HES). Hepatic b lood flow was measured noninvasively via indocyanine green (ICG) clear ance (indices: K [ICG disappearance rate] and R15 [15-min ICG retentio n 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 mu g.kg(-1).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 arteria l 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 an d E + D, K decreased and R15 increased slightly, hut 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 anesthes ia, despite normotension maintained by continuous infusion of HES, but that this decrease in flow is reversed by the addition of a dopamine infusion.