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July 1, 2026Journal of Clinical MedicineOpen Access

Preemptive Low-Dose Norepinephrine Infusion for Reducing Hemodynamic Instability During Craniotomy for Brain Tumor Resection Under Propofol–Remifentanil Total Intravenous Anesthesia: A Randomized Controlled Trial

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Authors

KMK. T. MinSCSeung Ho ChoiHKHyun Joo Kim

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Overview

Randomized trial evaluates preemptive norepinephrine infusion's effects on hemodynamic stability during brain surgery, suggesting benefits over conventional management.

Key Points

  • Assess the effectiveness of preemptive low-dose norepinephrine infusion in reducing hemodynamic instability during brain tumor resection.
  • Randomized controlled trial of adult patients undergoing craniotomy under propofol–remifentanil TIVA.
  • Patients received either preemptive norepinephrine infusion or conventional management with reactive norepinephrine use.
  • Primary endpoint measured was moderate or severe hemodynamic instability defined by mean arterial pressure thresholds.
  • CINE group had fewer moderate hemodynamic instability episodes per patient (median 6 vs. 9, p=0.045).
  • Anesthesia time affected by instability was less in CINE group (7.4% vs. 12.2%, p=0.017).
  • Rescue medication usage was significantly lower in the CINE group (16.7% vs. 100%, p<0.001).

Cite This Study

Min et al. (2026) studied this question.

synapsesocial.com/papers/6a44add75cd2549c8bc43347https://doi.org/10.3390/jcm15135046
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prophylactic infusion of norepinephrine enhances hemodynamic stability during propofol induction and early intubation period in elderly patients: a double-blind randomized placebo-controlled trial2026
  2. 2Early use of norepinephrine in high-risk patients undergoing major abdominal surgery: a randomized controlled trial2025 · 22 citations
  3. 3Effect of Remimazolam- versus Propofol-Based Total Intravenous General Anesthesia on Intraoperative Hemodynamic Stability for Major Spine Surgery in the Prone Position: A Randomized Controlled Trial2024 · 15 citations
  4. 4Comparative Study of Using Norepinephrine Infusion versus Dopamine in Hemodynamically Unstable Patients at Surgical Intensive Care Unit2025
  5. 5Propofol Infusion Versus Isoflurane/Nitroglycerine Combination for Controlled Hypotensive Anesthesia in Neurosurgery2023