Key result
Prophylactic norepinephrine infusion prevented post-spinal hypotension and maintained intraoperative hemodynamics as an alternative to phenylephrine in non-obstetric patients.
Why the study?
Phenylephrine causes reflex bradycardia and decreased cardiac output during spinal anesthesia, prompting interest in norepinephrine as an alternative with less impact on heart rate and cardiac output.
Does prophylactic intravenous infusion of norepinephrine prevent postspinal hypotension and maintain hemodynamics compared to phenylephrine in healthy patients undergoing lower abdominal surgery with spinal anesthesia?
RCT (n=38)
double-blind
randomized
Does prophylactic intravenous infusion of norepinephrine prevent postspinal hypotension and maintain hemodynamics compared to phenylephrine in healthy patients undergoing lower abdominal surgery with spinal anesthesia?
Prophylactic norepinephrine infusion is an effective alternative to phenylephrine for preventing postspinal hypotension while better preserving heart rate and cardiac output during non-obstetric surgery.
Answers are grounded in this paper and cite their sources.
Norepinephrine may reduce reflex bradycardia versus phenylephrine during spinal anesthesia; leaves open need for confirmatory RCTs before practice change.
Background: Although it is generally established that phenylepherine is the preferred vasopressor for maintaining blood pressure stability during spinal anesthesia, its use has been connected to a reflex decrease in heart rate and an associated decrease in cardiac output. As a result, research into substitute chemicals like norepinephrine has been sparked. When opposed to phenylephrine, norepinephrine may be more effective in controlling blood pressure because it has less of an impact on heart rate and cardiac output while still acting as a strong-adrenergic receptor agonist. Aim of Study: This study is to detect lowest MAP during the first 10 minutes after spinal anesthesia and compare the efficacy of prophylactic intravenous infusions of phenylepher-ine and norepinephrine in controlling hemodynamics in patients undergoing lower abdominal incision minor and intermediate surgical interventions (below T10) with spinal anesthesia. Patients and Methods: In our randomized, double-blinded study, 38 healthy patients undergoing lower abdominal incision surgical interventions under spinal anesthesia were randomized to maintain intraoperative hemodynamics with infusion of norepinephrine 4µg/ml or phenylephrine 100µg/ml. This study compared between both groups to detect lowest mean arterial pressure during the first 10 minutes after spinal anesthesia. Heart rate, cardiac output, stroke volume and index of cardiac output number using electrical cardiometry were also compared. Results: Norepinephrine may be more successful in low-ering blood pressure compared to phenylephrine because it has less of an effect on heart rate and cardiac output while still acting as a potent-adrenergic receptor agonist. Conclusion: The present study showed that prophylactic norepinephrine infusion as an alternative vasopressor to phenylephrine infusion prevented post spinal hypotension in non-obestetric patients and maintained intraoperative hemo-dynamics.
No takes yet. Share an insight, caveat, or question.
MOSTAFA et al. (2022) conducted an RCT in Healthy patients undergoing lower abdominal incision minor and intermediate surgical interventions with spinal anesthesia (n=38). Norepinephrine vs. Phenylephrine 100µg/ml infusion was evaluated on Lowest mean arterial pressure during the first 10 minutes after spinal anesthesia. Prophylactic norepinephrine infusion prevented post-spinal hypotension and maintained intraoperative hemodynamics as an alternative to phenylephrine in non-obstetric patients.
Synapse has enriched 10 related papers. Consider them for comparative context: