Ephedrine versus norepinephrine infusion for prevention of haemodynamic instability after declamping of the aorta in abdominal aortic aneurysm repair

Background: During general anesthesia, hypotension is often experienced and is linked to both postoperative morbidity and death. Anesthesiologists have long had a hurdle while performing abdominal aortic aneurysm (AAA) repair, a high-risk treatment that increases vulnerability to hemodynamic disturbances during open surgery. A common vasopressor that is a combined α- and β-agonist, ephedrine is used to treat hypotension in general anesthesia. Conversely, norepinephrine has a favorable chronotropic impact on the heart in addition to acting as an agonist for both α and ß receptors. Aim of the work: Examine the differences in the effects of intravenous ephedrine hydrochloride and noradrenaline on maintaining arterial pressure during aortic declamping during abdominal aortic aneurysm surgery. Patients and methods: The current research included sixty patients who were enrolled for surgical repair of abdominal aortic aneurysm who were randomly assigned into two groups, Group E (n = 30) which received intraoperative ephedrine infusion, and Group N (n = 30) that received intraoperative norepinephrine infusion. The main outcomes of the current study included intraoperative hemodynamic changes, including the prevalence of tachycardia, hypotension, bradycardia, and hypertension, the volume of the infusion needed, the time elapsed till infusion cessation, the need for extra drug bolus, the number of blouses given, and the prevalence of complications (nausea and vomiting). Results: According to the present investigation, there was no statistically substantial change in heart rate or mean arterial pressure (MAP) between the two study groups at follow-up. Compared to the NE group, the ephedrine group had a greater incidence of vasopressor demand (40%) but not to a statistically substantial level (p= 0.165). Also, the number of boluses, volume of infusion and the time to stop infusion were similar in the two groups. Conclusion: Ephedrine and norepinephrine controlled hemodynamic changes and alternations during AAA surgery similarly and effectively. NE reduced vasopressor doses, a slight advantage.