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November 1984

Abdominal Aortic Cross-Clamping: Metabolic and Hemodynamic Consequences

Author Affiliations

From the Departments of Anesthesiology (Drs Damask, Weissman, Rodriguez, Askanazi, Rosenbaum, and Hyman), Medicine (Drs Weissman and Rosenbaum), and Pediatrics (Dr Hyman), College of Physicians and Surgeons, Columbia University, New York.

Arch Surg. 1984;119(11):1332-1337. doi:10.1001/archsurg.1984.01390230098025

• We address the question of whether an oxygen debt develops during a period of abdominal aortic cross-clamping that may explain observed hemodynamic changes. Group 1 received morphine sulfate (1 mg/kg) during induction of anesthesia. Group 2 received same dose of morphine sulfate. Group 3 received 4 mg/kg of morphine sulfate. We measured the oxygen consumption (V̇o2) and the carbon dioxide production levels (V̇co2), as well as hemodynamic and biochemical parameters. In groups 1 and 3, V̇o2 and V̇co2 decreased 10% to 13% following abdominal aortic cross-clamping compared with values measured before cross-clamping. In group 2, V̇o2 and V̇co2 decreased 3% and 7%, respectively. On unclamping, the greatest increase in V̇o2 was observed in group 3 (26%), while in groups 1 and 2, V̇o2rose 18%and 5%, respectively. In all three groups, metabolic changes were not paralleled by hemodynamic or temperature changes. Results indicate that oxygen debt developed during abdominal aortic cross-clamping, but this has no effect on hemodynamic changes seen after unclamping. Higher dosage of narcotic administered during anesthetic induction did not temper increase in metabolic rate observed after unclamping.

(Arch Surg 1984:119:1332-1337)