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[Effect of dobutamine on the transport and consumption of oxygen during general anesthesia with enflurane].

We undertook a comparative study on the effects of dobutamine and placebo on hemodynamic parameters, O2 transport (DO2), O2 consumption (VO2, and acid lactic production during peripheral arterial surgery under general anesthesia with enflurane at a constant inspiratory concentration (1.2%). This study involved 18 patients older than 65 years (9 patients allocated in the dobutamine group and 9 in the placebo group). The hemodynamic course was monitorized by means of noninvasive methods such as the aortic output measured by continuous transoesophageal echo-Doppler. After introduction of enflurane into the circuit aortic output decreased by 39% in dopamine group and 36% in placebo. Total systemic vascular resistances increased by 52% in dopamine and by 48% in placebo treatment. DO2 showed a decrease of 39% in dopamine and 38% in placebo group. There were no appreciable differences in VO2 among the two groups. Recovery of hemodynamic parameters and DO2 was only observed in the dopamine group when the drug was perfused at a rate of 4 +/- 1.2 micrograms/kg/min. Dobutamine induced a transient increase of VO2 up to 225% of the baseline value. During the postanesthetic period VO2 and blood acid lactic were significantly higher in the dopamine than in the placebo group (192%, p less than 0.01 and 33%, p less than 0.05, respectively). The course of hemodynamic parameters, DO2, VO2, and blood acid lactic of dobutamine group appear to demonstrate that dobutamine perfusion reverts myocardial depression and improves cellular perfusion during general anesthesia with enflurane.