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5 Versus 10 mcg Norepinephrine Bolus in Treatment of Postinduction and Early Intraoperative Hypotension in Emergency Abdominal Surgery

4. august 2026 opdateret af: Ahmed Hasanin, Cairo University

Comparing 5 mcg and 10 mcg Norepinephrine Bolus in Treatment of Postinduction and Early Intraoperative Hypotension in Emergency Abdominal Surgery: a Randomized Controlled Trial

Postinduction hypotension is a frequent intraoperative complication, particularly in emergency abdominal surgery due to factors such as sepsis, hypovolemia, and limited preoperative cardiac assessment. Because it can lead to serious organ injury, prompt prevention and management are essential. Vasopressors, including ephedrine, phenylephrine, and norepinephrine, are commonly used, with NE gaining interest as an intraoperative bolus despite uncertainty about the optimal dose in general surgery population The aim of this study is to compare 5 mcg to 10 mcg norepinephrine bolus for treatment of postinduction hypotension and early intraoperative in emergency abdominal surgery.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

fluid assessment using stroke volume change after passive leg raising maneuver will be applied. If stroke volume increase >10%, 500-mL bolus of lactated ringer will be given. Passive leg raising will be repeated until the patient is non-responder or 1500 mL were infused.

intraoperatively, heart rate and blood pressure will be monitored at 2 min intervals until 30 min after skin incision.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

136

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Egypten
    • Cairo Governorate
      • Cairo, Cairo Governorate, Egypten

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Adult patients, American Society of anesthesiologists (ASA) I-III undergoing emergency abdominal surgery

Exclusion Criteria:

  • Severe cardiac morbidities (impaired contractility with ejection fraction < 45%, heart block, arrhythmias, tight valvular lesions)
  • Patients on vasopressor infusion,
  • Pregnant or lactating women,
  • Allergy of any of the study drugs

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Tredobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Norepinephrine 5-mcg group
The study drug will be prepared by diluting 4000 mcg of NE in 400 mL of normal saline to achieve a concentration of 10 mcg/mL. The assigned dose (5 mcg, 0.5 mL of the prepared solution) will then be further diluted with normal saline in a 10-mL syringe.
Medicin: Norepinephrine 5 mcg
Norepinephrine dose of 5 mcg will be given if patient developed hypotension (mean arterial pressure <65 mmHg). The norepinephrine bolus (5 mcg) will be repeated if mean arterial pressure is not restored within 2 min. Norepinephrine infusion will be started if hypotension persisted after three boluses.
Aktiv komparator: Norepinephrine 10-mcg group
The study drug will be prepared by diluting 4000 mcg of NE in 400 mL of normal saline to achieve a concentration of 10 mcg/mL. The assigned dose (10 mcg, 1 mL of the prepared solution) will then be further diluted with normal saline in a 10-mL syringe.
Medicin: Norepinephrine 10 mcg
Norepinephrine dose of 10 mcg will be given if patient developed hypotension (mean arterial pressure <65 mmHg). The norepinephrine bolus (10 mcg) will be repeated if mean arterial pressure is not restored within 2 min. Norepinephrine infusion will be started if hypotension persisted after three boluses.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Incidence of successfully managed hypotensive episode
Tidsramme: from 0 min of induction of anesthesia until 30 min after skin incision
mean arterial pressure >65 mmHg within 2 min of drug administration
from 0 min of induction of anesthesia until 30 min after skin incision

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Area under a mean arterial pressure of 65 mmHg
Tidsramme: from 0 min of induction of anesthesia until 30 min after skin incision
The area under a mean arterial pressure (MAP) of 65 mm Hg will be calculated by subtracting MAP measurements from 65 mm Hg, multiplying positive differences with the time difference (in minutes) between this MAP measurement and the consecutive MAP measurement, and summing the values
from 0 min of induction of anesthesia until 30 min after skin incision
Duration of MAP<65 mmHg
Tidsramme: from 0 min after induction of anesthesia until 30 min after skin incision
in minutes
from 0 min after induction of anesthesia until 30 min after skin incision
bradycardia
Tidsramme: from 0 min after induction of anesthesia until 30 min after skin incision
heart rate < 50 bpm following drug administration
from 0 min after induction of anesthesia until 30 min after skin incision
hypertension
Tidsramme: from 0 min after induction of anesthesia until 30 min after skin incision
systolic blood pressure >120% of baseline following drug administration
from 0 min after induction of anesthesia until 30 min after skin incision

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Cairo University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

4. august 2026

Primær færdiggørelse (Anslået)

1. december 2026

Studieafslutning (Anslået)

1. december 2026

Datoer for studieregistrering

Først indsendt

17. juli 2026

Først indsendt, der opfyldte QC-kriterier

17. juli 2026

Først opslået (Faktiske)

22. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

5. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • MS-303-2026

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

data related to this research is available form the PI upon reasonable request

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