What question did this study set out to answer?

To evaluate and compare the effects of phenylephrine and norepinephrine on systemic hemodynamics, cerebral tissue oxygenation, and peripheral tissue oxygenation during anesthesia-induced hypotension.

March 11, 2015European Journal of Anaesthesiology

Differential effects of phenylephrine and norepinephrine on peripheral tissue oxygenation during general anaesthesia

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Authors

MPMarieke PotermanUniversity Medical Center Groningen JVJaap Jan VosUniversity Medical Center Groningen HVHugo VereeckeUniversity Medical Center Groningen

Discussion

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Implication

Randomized trial observes equivalent cardiovascular restoration between phenylephrine and norepinephrine under general anesthesia, indicating both safely reverse drug-induced hypotension.

Key Points

To evaluate and compare the effects of phenylephrine and norepinephrine on systemic hemodynamics, cerebral tissue oxygenation, and peripheral tissue oxygenation during anesthesia-induced hypotension.
Single-centre randomized controlled trial in the Netherlands including 60 normovolaemic patients under balanced propofol/remifentanil anesthesia.
Patients received either phenylephrine (100 μg bolus + 0.5 μg kg⁻¹ min⁻¹) or norepinephrine (10 μg bolus + 0.05 μg kg⁻¹ min⁻¹) upon mean arterial pressure (MAP) dropping below 80% of baseline.
Systemic hemodynamics (MAP, HR, SV, CI, RPP) and regional tissue oxygenation (cerebral SctO2 and peripheral SptO2) were tracked from 30 s before to 240 s post-administration.
Both phenylephrine and norepinephrine induced an identical increase in MAP [Δ = 13 (8 to 22) vs Δ = 13 (9 to 19) mmHg] and stroke volume [Δ = 6 ± 6 vs Δ = 5 ± 7 ml].
Both agents caused equivalent decreases in heart rate (both Δ = -8 ± 6 bpm), cardiac index (both Δ = -0.2 ± 0.3 l min⁻¹ m⁻²), and cerebral tissue oxygenation.
Peripheral tissue oxygenation decreased significantly following norepinephrine [Δ = -3 (-6 to 0)%, P < 0.05] but remained stable after phenylephrine [Δ = 0 (-1 to 1)%], though values in both arms remained above pre-anesthesia baseline.

Cite This Study

Poterman et al. (2015) studied this question.

synapsesocial.com/papers/6a75f00467b8a7e548707232 https://doi.org/10.1097/eja.0000000000000247

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Implication

Randomized trial observes equivalent cardiovascular restoration between phenylephrine and norepinephrine under general anesthesia, indicating both safely reverse drug-induced hypotension.

Differential effects of phenylephrine and norepinephrine on peripheral tissue oxygenation during general anaesthesia

Discussion

Member takes

Implication

Key Points

Cite This Study

Differential effects of phenylephrine and norepinephrine on peripheral tissue oxygenation during general anaesthesia

Discussion

Member takes

Implication

Key Points

Cite This Study

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