期刊论文详细信息
Korean Journal of Anesthesiology
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
Maha Mostafa1  Ahmed Hasanin1  Ashraf Rady1  Mai Y Taha1  Mahmoud Mostafa1  Mohamed Elsayad1  Bassant Abdelhamid1  Fatma Alzahraa Haggag1  Omar Taalab2 
[1] Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt;Department of Orthopedic Surgery, Cairo University, Cairo, Egypt;
关键词: elderly;    hip fracture surgery;    hypotension;    norepinephrine;    phenylephrine;    spinal anesthesia;   
DOI  :  10.4097/kja.20519
来源: DOAJ
【 摘 要 】

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 = 0.031) 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.

【 授权许可】

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