Overview
Postinduction hypotension is a frequent intraoperative complication, particularly in emergency abdominal surgery due to factors such as sepsis, hypovolemia, and limited preoperative cardiac assessment. Because it can lead to serious organ injury, prompt prevention and management are essential. Vasopressors, including ephedrine, phenylephrine, and norepinephrine, are commonly used, with NE gaining interest as an intraoperative bolus despite uncertainty about the optimal dose in general surgery population The aim of this study is to compare 5 mcg to 10 mcg norepinephrine bolus for treatment of postinduction hypotension and early intraoperative in emergency abdominal surgery.
Description
fluid assessment using stroke volume change after passive leg raising maneuver will be applied. If stroke volume increase \>10%, 500-mL bolus of lactated ringer will be given. Passive leg raising will be repeated until the patient is non-responder or 1500 mL were infused.
intraoperatively, heart rate and blood pressure will be monitored at 2 min intervals until 30 min after skin incision.
Eligibility
Inclusion Criteria:
- Adult patients, American Society of anesthesiologists (ASA) I-III undergoing emergency abdominal surgery
Exclusion Criteria:
- Severe cardiac morbidities (impaired contractility with ejection fraction \< 45%, heart block, arrhythmias, tight valvular lesions)
- Patients on vasopressor infusion,
- Pregnant or lactating women,
- Allergy of any of the study drugs
