Pediatric anesthesia & critical care
Effective dose of ephedrine for treatment of hypotension after induction of general anaesthesia in neonates and infants less than 6 months of age: a multicentre randomised, controlled, open label, dose escalation trial
Authors' conclusion
Doses of ephedrine much higher (∼10-fold) than those used in adults are necessary in neonates and infants for the treatment of hypotension after induction of general anaesthesia with sevoflurane.
Study context
- Population
- Neonates and infants <6 months with hypotension (>20% change from baseline in MAP) after induction of GA with sevofluranereceived allocated dose
- Participants
- 119 neonates
- Comparison
- Escalating ephedrine doses vs reference dose 0.1 mg kg-1 i. v.
- Primary endpoint
- Return of MAP to >80% of baseline at least once
- Follow-up
- Within 10 min after ephedrine administration
Methodological detailsmulticentre, prospective, open-label, dose-escalation, Six cohorts of 20 subjects each; 10 per cohort assigned to next higher dose, others to doses already investigated
- Multicentre
- Prospective
- Open-label
- Dose-escalation
- Six cohorts of 20 subjects each; 10 per cohort assigned to next higher dose, others to doses already investigated
Primary result
As reported in the abstract
Optimal dose of ephedrine
| Group | Value | Percentage of success |
|---|---|---|
| 1.2 mg kg-1 | 65.5% (95% CI 35.6–86.4) | 65.5% |
1.2 mg kg-1
Value65.5% (95% CI 35.6–86.4)
Percentage of success65.5%
Safety
- The doses of ephedrine investigated did not induce adverse events
Original publication
Effective dose of ephedrine for treatment of hypotension after induction of general anaesthesia in neonates and infants less than 6 months of age: a multicentre randomised, controlled, open label, dose escalation trial. Br J Anaesth. Published 12 January 2023. doi:10.
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