Norepinephrine prophylaxis for postspinal anesthesia hypotension in parturient undergoing cesarean section: a randomized, controlled trial.
Adult
Anesthesia, Obstetrical
/ adverse effects
Anesthesia, Spinal
/ adverse effects
Blood Pressure
Bradycardia
/ chemically induced
Cesarean Section
/ adverse effects
China
/ epidemiology
Female
Humans
Hypertension
/ chemically induced
Hypotension
/ epidemiology
Infant, Newborn
Infusions, Parenteral
/ adverse effects
Middle Aged
Nausea
/ chemically induced
Norepinephrine
/ administration & dosage
Pre-Exposure Prophylaxis
/ methods
Pregnancy
Treatment Outcome
Vasoconstrictor Agents
/ administration & dosage
Vomiting
/ chemically induced
Young Adult
Cesarean section
Hypotension
Inferior vena cava collapsibility index
Norepinephrine
Spinal anesthesia
Journal
Archives of gynecology and obstetrics
ISSN: 1432-0711
Titre abrégé: Arch Gynecol Obstet
Pays: Germany
ID NLM: 8710213
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
21
04
2020
accepted:
18
06
2020
pubmed:
27
6
2020
medline:
18
11
2020
entrez:
27
6
2020
Statut:
ppublish
Résumé
To investigate the efficacy and safety of prophylactic infusion of norepinephrine (NE) versus normal saline in patients undergoing cesarean section. Patients (n = 97) were randomized to receive a bolus of NE (6 μg) immediately following spinal anesthesia with maintenance NE (0.05 μg/kg/min IV) or normal saline (n = 98). The primary endpoint was the incidence of postspinal anesthesia hypotension [systolic blood pressure (SBP) < 80% of baseline] at 1-20 min following spinal anesthesia. Secondary outcomes were the overall stability of SBP control versus baseline, inferior vena cava collapsibility index (IVC-CI), other adverse events (bradycardia, nausea, vomiting, and hypertension), and neonatal outcomes (blood gas values and Apgar scores). The rates of postspinal anesthesia hypotension and severe postspinal anesthesia hypotension (SBP < 60% of the baseline) were significantly lower in the NE group (17.5% vs. 62.2%, p < 0.001; 7.2% vs. 17.4%, p = 0.031). In the NE group, SBP remained more stable and closer to baseline (p < 0.001), and IVC-CI values were lower 5 min after spinal anesthesia and 5 min after fetal delivery (p = 0.045; p < 0.001, respectively). Other adverse effects and neonatal outcomes were not different between the two groups. Prophylactic NE infusion effectively lowers the incidence of postspinal anesthesia hypotension and does not increase other adverse events in patients or neonates.
Identifiants
pubmed: 32588134
doi: 10.1007/s00404-020-05663-7
pii: 10.1007/s00404-020-05663-7
doi:
Substances chimiques
Vasoconstrictor Agents
0
Norepinephrine
X4W3ENH1CV
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM