Norepinephrine versus vasopressin infusion for prevention of spinal-induced hypotension: a placebo-controlled study

Southern African Journal of Anaesthesia and Analgesia

 
 
Field Value
 
Title Norepinephrine versus vasopressin infusion for prevention of spinal-induced hypotension: a placebo-controlled study
 
Creator Mohamed, Ahmed Abdalla Safan, Tamer Fayez
 
Subject — nor-epinephrine; prophylaxis; spinal anaesthesia-induced hypotension; vasopressin
Description Objectives: To evaluate the prophylactic effect of norepinephrine (NE) and vasopressin (VP) infusion on frequency and severity of spinal anaesthesia-induced hypotension (SAIH). Patients and methods: A total of 240 young male patients were randomly allocated into three equal groups: Group C received plain saline infusion, Group NE received NE infusion (0.1 mg/ml; 3 ml/h) and Group VP received VP infusion (0 5 U/ml; 1 U/h); all infusions started synchronously with spinal injection (SI). Systolic arterial pressure (SAP) and heart rate (HR) measures were determined at 1, 4, 7 and 10-min; then every 5-min for 30 min. SAP reduction of 10% was treated by supplementary fluid therapy and resistant cases or patients who had SAP reduction of ≥20% received ephedrine (10 mg). Results: In comparison with baseline SAP, SAP was decreased by 20% in eight control patients, by 10% in 22 patients and in 50 control patients SAP decrease ranged between 10% and 20%. In the NE and VP groups, no patient had decreased SAP of 10%, while 15 patients had increased SAP of 10% and 145 patients showed no SAP change with significant difference between the two groups (p = 0.0003). Throughout the 30 min after spinal block, all SAP and HR measures of control patients were significantly (p = 0.001) lower compared with their baseline measures and with corresponding measures of patients of the NE and VP groups with non-significant difference between the two groups. Seven patients (8.8%) in the control group had nausea and three (3.8%) had nausea and vomiting, while no patient in the NE and VP groups had nausea or required anti-emetic therapy. Conclusion: Vasopressor infusion given synchronously with spinal injection is an appropriate prophylactic policy against SAIH. NE infusion did better than VP infusion and provided better haemodynamic stability after spinal injection. However, VP infusion allowed control of blood pressure despite the significant decrease till 7 min after SI.
 
Publisher AOSIS
 
Contributor
Date 2017-08-30
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format application/pdf
Identifier 10.1080/22201181.2017.1338333
 
Source Southern African Journal of Anaesthesia and Analgesia; Vol 23, No 4 (2017); 96-101 2220-1173 2220-1181
 
Language eng
 
Relation
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https://sajaa.co.za/index.php/sajaa/article/view/1074/1065
 
Coverage — — —
Rights Copyright (c) 2017 Ahmed Abdalla Mohamed, Tamer Fayez Safan http://creativecommons.org/licenses/by-nc/3.0
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