Key result
Norepinephrine infusion was superior to 5 μg boluses in maintaining mean arterial blood pressure, stroke volume, and cardiac index after spinal anaesthesia for caesarean section (P < 0.001).
Why the study?
Hypotension commonly occurs after spinal anaesthesia due to sympathetic inhibition, prompting evaluation of norepinephrine infusion to maintain hemodynamics during caesarean section.
Does norepinephrine infusion improve hemodynamic stability compared to bolus norepinephrine in female patients undergoing caesarean section under spinal anaesthesia?
RCT (n=40)
Does norepinephrine infusion improve hemodynamic stability compared to bolus norepinephrine in female patients undergoing caesarean section under spinal anaesthesia?
Norepinephrine infusion provides superior maintenance of blood pressure, stroke volume, and cardiac index compared to 5 μg boluses during spinal anaesthesia for caesarean delivery, without adverse fetal effects.
Norepinephrine infusion may better maintain hemodynamics than boluses in spinal caesarean anesthesia; hypothesis-generating, needs randomized confirmation.
Objectives: The current study was designed to evaluate the role of norepinephrine infusion in maintaining hemodynamics stable in patients undergoing caesarean section Background: Hypotension commonly occurred after spinal anaesthesia and this is caused by sympathetic system inhibition. Methods: Forty female patients undergoing caesarean section were divided into two groups. Group 1 received norepinephrine infusion and group 2 received bolus norepinephrine. Blood pressure, heart rate, cardiac index, stroke volume and systemic vascular resistance were recorded as a baseline and every 10 minutes after intrathecal injection. Results: The mean arterial blood pressure showed a significant reduction in group 2 compared to group 1 at all times of measurement (P < 0.001). Both stroke volume and cardiac index revealed a significant increase in group 1 compared to group 2 (P < 0.001 and > 0.003 respectively). There was no significant difference between both groups as regard systemic vascular resistance, heart rate, thoracic volume variation as well APGAR score at 5 min and 10 min after delivery. Conclusion: Norepinephrine infusion when compared with boluses of 5 μg norepinephrine is superior in maintaining blood pressure, stroke volume and cardiac index after spinal anaesthesia in caesarean section without adverse effects on the baby.
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Mansour et al. (2023) conducted an RCT in Hypotension during spinal anaesthesia for caesarean delivery (n=40). Norepinephrine infusion vs. Bolus norepinephrine (5 μg) was evaluated on Mean arterial blood pressure (p=< 0.001). Norepinephrine infusion was superior to 5 μg boluses in maintaining mean arterial blood pressure, stroke volume, and cardiac index after spinal anaesthesia for caesarean section (P < 0.001).
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