The Effect of Epinephrine, Norepinephrine and Phenylephrine on Intraoperative Hemodynamic Performance

• Status: Not yet recruiting
• Trial end date: 2024-08-31
• Target enrollment: 0
• Participant gender: All

Summary

The use of catecholamines for blood pressure and hemodynamic management is essential during undergoing surgery. The type of the catecholamine with the most clinical meaningful effect is still unknown. Therefore, the investigators evaluate the effect of intraoperative continuous infusion of epinephrine, norepinephrine and phenylephrine on intraoperative cardiac output. The investigators further evaluate the effect of epinephrine, norepinephrine and phenylephrine on regional brain and regional tissue oxygenation during surgery.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Medical University of Vienna
• Collaborator: Medical University of Graz
• Treatments: Epinephrine; Norepinephrine; Oxymetazoline; Phenylephrine

Criteria

Inclusion Criteria:

• ≥ 45 years old

• Scheduled for moderate- to high-risk major open abdominal surgery expected to last at least two hours

• ASA physical status ≥ 2

• At least one of the following risk factors:

1. Age ≥75years

2. History of peripheral arterial disease

3. History of coronary artery disease

4. History of stroke or transient ischemic attack/Stroke

5. History of chronic kidney disease

6. Diabetes requiring medical treatment

7. Current smoking or history of 15 pack-years

8. History of heart failure

9. Preoperative high-sensitivity Troponin T ≥14ng.L-1

10. Preoperative NT-proBNP ≥200 pg.mL-1

Exclusion Criteria:

1. Scheduled for pheochromocytoma surgery

2. Scheduled for liver and kidney transplantation

3. Requiring preoperative intravenous vasopressor medications

4. Contraindications to epinephrine, norepinephrine or phenylephrine per clinical judgement

5. Permanent atrial fibrillation

6. Preoperative heart rate >110 bpm