Premium
Increased spillover of norepinephrine to the portal vein during CO 2 ‐pneumoperitoneum in pigs
Author(s) -
Myre K.,
Rostrup M.,
Eriksen M.,
Buanes T.,
Ræder J.,
Stokland O.
Publication year - 2004
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.0001-5172.2004.00366.x
Subject(s) - medicine , norepinephrine , catecholamine , pneumoperitoneum , femoral vein , epinephrine , anesthesia , surgery , laparoscopy , dopamine
Background: Elevated intra abdominal pressure (IAP) during CO 2 ‐insufflation has been associated with increased catecholamine concentrations in plasma. We have previously indicated that this may be due to a regional increased spillover from the abdominal region. In this experimental study we investigated catecholamine spillover from the drainage area of the portal vein during CO 2 ‐pneumoperitoneum. Methods: Eight pigs under general anesthesia were investigated before and after CO 2 ‐pneumoperitoneum with an IAP of 15 mmHg. Regional spillover of catecholamines was determined by measuring plasma catecholamine concentrations and flow simultaneously. Plasma concentrations of catecholamines were measured from the portal and femoral veins, the pulmonary and carotid arteries. Flow data were collected with laser‐Doppler transit time flow probes around the portal and femoral veins. Cardiac output was measured by the thermo‐dilution technique. Estimated spillover was calculated by the veno‐arterial difference multiplied by flow. Results: We found a significant increase in estimated spillover of norepinephrine from the drainage area of the portal vein from 10 (−1.2, 78) ng·min −1 to 27 (1.8, 475) ng·min −1 [median (range)] ( P = 0.05), but no change in estimated spillover of norepinephrine from the drainage area of the femoral vein. Plasma concentrations of norepinephrine increased in central venous and arterial blood. There was no significant change in epinephrine concentrations in arterial blood. Conclusion: Estimated norepinephrine spillover from the drainage area of the portal vein increased during CO 2 ‐pneumoperitoneum in pigs. This may indicate that the increased norepinephrine concentrations found in arterial plasma reflects a local activation of sympathetic nerves in the region of the portal drainage area.