Differential effects of phenylephrine and norepinephrine on peripheral tissue oxygenation during general anaesthesia: A randomised controlled trial

European Journal of Anaesthesiology
Marieke PotermanAlain F Kalmar

Abstract

Phenylephrine and norepinephrine are two vasopressors commonly used to counteract anaesthesia-induced hypotension. Their dissimilar working mechanisms may differentially affect the macro and microcirculation, and ultimately tissue oxygenation. We investigated the differential effect of phenylephrine and norepinephrine on the heart rate (HR), stroke volume (SV), cardiac index (CI), cerebral tissue oxygenation (SctO2) and peripheral tissue oxygenation (SptO2), and rate-pressure product (RPP). A randomised controlled study. Single-centre, University Medical Center Groningen, The Netherlands. Sixty normovolaemic patients under balanced propofol/remifentanil anaesthesia. If the mean arterial pressure (MAP) dropped below 80% of the awake state value, phenylephrine (100 μg + 0.5 μg kg(-1) min(-1)) or norepinephrine (10 μg + 0.05 μg kg(-1) min(-1)) was administered in a randomised fashion. MAP, HR, SV, CI, SctO2, SptO2 and rate-pressure product (RPP) analysed from 30 s before drug administration until 240 s thereafter. Phenylephrine and norepinephrine caused an equivalent increase in MAP [Δ = 13 (8 to 22) and Δ = 13 (9 to 19) mmHg, respectively] and SV [Δ = 6 ± 6 and Δ = 5 ± 7 ml, respectively], combined with a significant equivalent d...Continue Reading

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Citations

Dec 18, 2016·Journal of Clinical Monitoring and Computing·H SørensenN H Secher
Mar 2, 2017·European Journal of Anaesthesiology·Michelle S Chew, Bernhard Walder
Apr 6, 2017·Clinical and Experimental Pharmacology & Physiology·Jugurtha AlianePierre Schoeffler
Sep 29, 2018·Journal of Clinical Monitoring and Computing·Karin H WodackDaniel A Reuter
Sep 15, 2020·Anesthesia and Analgesia·Tjorvi E Perry, Richard C Prielipp
Apr 23, 2021·Anesthesia and Analgesia·W Brenton FrenchMichael J Scott
Oct 28, 2019·Journal of Neurosurgical Anesthesiology·Sebastian R Gatica-MorisJeffrey J Pasternak

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NCT01609491

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