Impact of dopamine and endothelin-1 antagonism on portal venous blood flow during laparoscopic surgery

Abstract

Dopamine and ET-1 antagonism restore portal blood flow during laparoscopic surgery independently of the insufflation gas. Whether improved hepatic perfusion might have beneficial effects on liver function needs further investigation.

Carbon dioxide pneumoperitoneum-related liver injury is pressure dependent: A study in an isolated-perfused organ model

“…The net effect was tissue hypoxia that lasted as long as two hours after desufflation. Another study [12] demonstrated that the reduction in portal flow was independent of the gas used (CO 2 vs. helium) and that it was successfully counteracted by dopamine. Studies using indocyanine green uptake also demonstrated a significant reduction in liver blood flow in pigs [19].…”

Validation and Reduction of the Oxidative Stress Following Laparoscopic Operations

“…[15][16][17][18][19][20][21][22][23][24][25][26] Several solutions have been raised to overcome the above deranged hemodynamic effects, including gasless surgery, substituting different gases for CO 2 , fluid overload, and various pharmacologic means. [27][28][29] A mechanical solution raised by Bickel involves using an intermittent sequential pneumatic compression (ISPC) device to improve venous return and cardiac function. 30,31 This device was shown to reverse the hemodynamic changes and the cardiac autonomic control, as well as the hepatic and renal (visceral) perfusion.…”

Helix Induction by Dirhodium: Access to Biocompatible Metallopeptides with Defined Secondary Structure

“…Various pharmacological agents have been tested to combat oxidative stress, and some antioxidants and vasodilators have been shown to be successful in animal models78, 108, 109. Administration of dopamine and endothelin 1 antagonists greatly improved the portal circulation in rats subjected to carbon dioxide and helium insufflation, but oxidative stress markers were not measured109. Pretreatment with the calcium channel antagonist verapamil significantly reduced oxidant levels and increased antioxidant levels in a rabbit model of retroperitoneoscopy16.…”