Randomized, Double-blind, Controlled Clinical Trial for Comparison of Continuous Phenylephrine Versus Norepinephrine Infusion for Maintenance of Hemodynamic Stability During Cesarean Section Under Spinal Anesthesia
Description:
Maternal hypotension is a frequent complication after spinal anesthesia for cesarean
delivery. Many vasopressors have been studied and used, but the perfect vasopressor is yet to
be found. Phenylephrine is the most common used in obstetric anesthesia but its cardiac
depressant activity, being an only alpha-adrenergic agonistic, is linked to frequent side
effects such as bradycardia and decreased cardiac output.
Norepinephrine is a vasopressor characterized by both alpha and minor beta-adrenergic
agonistic activity, it has then a minimal cardiac depressant activity. Hence it would provide
a better stability of hemodynamic and cardiac output, and appears as a better alternative to
phenylephrine.
In this study, the investigators will compare prophylactic continuous variable infusion of
both vasopressors. Phenylephrine started at the dose of 0,5mcg/kg/min and Norepinephrine
tartrate started at the dose of 0,1mcg/kg/min. The doses will be adjusted according to
maternal systolic blood pressure in order to prevent hypotension (defined by a systolic blood
pressure under 80% of baseline).
Condition:
Cesarean Section Complications
Treatment:
Norepinephrine
Start Date:
February 27, 2019
Sponsor:
Centre Hospitalier Régional d’Orléans
For More Information:
https://clinicaltrials.gov/show/NCT03849508