Norepinephrine has emerged as a potential alternative for stabilizing blood pressure during spinal anesthesia for cesarean section, purportedly maintaining maternal heart rate and cardiac output more effectively than phenylephrine. However, its application as an intravenous bolus for treating hypotension remains underexplored. Consequently, this current investigation aimed to determine the ED50 and ED95 of norepinephrine for managing maternal hypotension during cesarean section. A prospective trial enrolled 100 patients undergoing elective delivery under spinal anesthesia, with norepinephrine dosage determined using the upper and lower sequential distribution method (UDM).
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Single group
Norepinephrine
DrugParticipants in this arm will receive norepinephrine as a bolus dose to treat maternal hypotension during cesarean section under spinal anesthesia. The dosage will be determined using the upper and lower sequential distribution method (UDM). The aim is to investigate the effective dose (ED50 and ED95) of norepinephrine in maintaining maternal blood pressure stability and optimizing maternal outcomes during the procedure.
Intravenous norepinephrine to maintain maternal systolic blood pressure 80% above baseline before fetal delivery.
Intravenous norepinephrine pumped to maintain maternal systolic blood pressure 80% above its basal value prior to delivery of the foetus
Intraoperative adverse reactions
Dizziness, chest tightness, nausea, vomiting, bradycardia, secondary hypertension and other adverse reactions
Number of remedial drugs
Includes incidence of remedial use of atropine, incidence of remedial use of norepinephrine.
Neonatal Apgar score
Neonatal 1-min and 5-min Apgar scores
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