Evaluation of the Early Use of Norepinephrine in Major Abdominal Surgery on Postoperative Organ Dysfunction

• Status: Recruiting
• Trial end date: 2025-04-01
• Target enrollment: 0
• Participant gender: All

Summary

Hemodynamic instability is frequent during surgery and intraoperative hypotension is associated with excess morbidity and excess mortality in high-risk patients. In major abdominal surgery the incidence of intraoperative hypotension remains high.

For the past few years, some teams have proposed evaluating norepinephrine as a first-line drug in the presence of hypotension or even before hypotension occurs Thus in obstetrics, the preventive use of norepinephrine for cesareans performed under spinal anesthesia was associated with a reduction in the incidence of hypotension per operative without deleterious effect for the newborn or parturient. In the absence of any observed complications, several teams began to use noradrenaline prophylactically in other surgery. However, no study has demonstrated its benefit, particularly the term of surgical complication in abdominal surgery. The objective of this work is to assess the preventive use of norepinephrine in major abdominal surgery on the occurrence of intraoperative hypotension, postoperative organ dysfunction and postoperative medical and surgical complications.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Centre Hospitalier Universitaire, Amiens
• Treatments: Ephedrine; Norepinephrine

Criteria

Inclusion Criteria:

• Patients scheduled for major abdominal surgery

• ASA 2 or more patients

• Adults> 50 years old

• Patients eligible for general anesthesia

Exclusion Criteria:

• Patients scheduled for will be excluded and excluded from the study:

• ASA 1

• Children and adults- Urgent surgery

• Allergy to a product used in the study

• Severe untreated or uncontrolled high blood pressure despite taking medication

• Acute cardiovascular event, including acute or decompensated heart failure and acute coronary syndrome

• Chronic kidney disease with a glomerular filtration rate of less than 30 ml / min / 1.73 m2 or requiring renal replacement treatment in the event of end-stage renal failure

• Preoperative sepsis

• Circulatory shock

• Preoperative noradrenaline infusion before entering the study

• Surgical procedure under regional anesthesia (epidural and spinal anesthesia)

• No affiliation with the French health system

• Participation in another concurrent intervention study

• Refusal to participate

• Pregnant or lactating women