Hemodynamic effects of norepinephrine versus phenylephrine infusion for prophylaxis against spinal anesthesia-induced hypotension in the elderly population undergoing hip fracture surgery: a randomized controlled trial
| Autor: | Mahmoud M. Mostafa, Bassant Abdelhamid, Ahmed Hasanin, Maha Mostafa, Ashraf Rady, Omar Taalab, Fatma Alzahraa Haggag, Mai Younes Taha, Mohamed Elsayad |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Bradycardia
Cardiac output hypotension Hypotension Controlled hip fracture surgery Anesthesia Spinal elderly law.invention norepinephrine Norepinephrine (medication) 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Pregnancy 030202 anesthesiology law Anesthesiology Heart rate medicine Humans Vasoconstrictor Agents RD78.3-87.3 Phenylephrine spinal anesthesia Aged Clinical Research Article Cesarean Section business.industry Incidence (epidemiology) Hemodynamics 030208 emergency & critical care medicine phenylephrine Anesthesiology and Pain Medicine Mean blood pressure Anesthesia Female medicine.symptom business medicine.drug |
| Zdroj: | Korean Journal of Anesthesiology, Vol 74, Iss 4, Pp 308-316 (2021) Korean Journal of Anesthesiology |
| ISSN: | 2005-7563 2005-6419 |
| Popis: | Background: Elderly population are at increased risk of spinal anesthesia-induced hypotension increasing their risk for postoperative morbidity and mortality. This study aimed to compare the hemodynamic effects of prophylactic infusion of norepinephrine (NE) versus phenylephrine (PE) in elderly patients undergoing hip fracture surgery under spinal anesthesia. Methods: Elderly patients scheduled for hip fracture surgery were randomized to receive either NE infusion (8 µg/min) (NE group, n = 31) or PE infusion (100 µg/min) (PE group, n = 31) after spinal anesthesia. Outcomes included mean heart rate, mean blood pressure, cardiac output, incidence of spinal anesthesia-induced hypotension, incidence of bradycardia, and incidence of hypertension. Results: Sixty-two patients with a mean age of 71 ± 6 years were included in the final analysis (31 patients in each group). The NE group showed a higher mean heart rate and cardiac output than the PE group. The NE group had a lower incidence of reactive bradycardia (10% vs. 36%, P = 0.03) and hypertension (3% vs. 36%, P = 0.003) than the PE group. No study participant developed hypotension, and the mean blood pressure was comparable between the two groups. Conclusions: Both NE and PE infusions effectively prevented spinal anesthesia-induced hypotension in elderly patients undergoing hip fracture surgery. However, NE provided more hemodynamic stability than PE; maintaining the heart rate, higher cardiac output, less reactive bradycardia, and hypertension. |
| Databáze: | OpenAIRE |
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