Perioperative medicine & outcomes
Norepinephrine versus phenylephrine for treating hypotension during general anaesthesia in adult patients undergoing major noncardiac surgery: a multicentre, open-label, cluster-randomised, crossover, feasibility, and pilot trial
Authors' conclusion
A large and diverse population undergoing major surgery under general anaesthesia was successfully enrolled and randomised to receive NE or PE infusion.
Study context
- Population
- Adults under GA for major noncardiac surgery, five hospitals in Californiaenrolled over 6 months
- Participants
- 3,626 participants
- Comparison
- Norepinephrine vs phenylephrine infusion as first-line vasopressor
- Norepinephrine (NE)n = 1,809
- Phenylephrine (PE)n = 1,817reference
- Primary endpoint
- First-line vasopressor administration compliance of 80% or higher
Methodological detailsmulticentre, open-label, cluster-randomised, crossover, feasibility, pilot
- Multicentre
- Open-label
- Cluster-randomised
- Crossover
- Feasibility
- Pilot
Primary result
As reported in the abstract
First-line vasopressor compliance
Overall received the assigned first-line vasopressor
88.2%
Secondary outcomes
| Outcome | aOR | |
|---|---|---|
| Readmission within 30 days | 0.92 (95% CI 0.6–1.39) | |
| 30-day mortality | 1.01 (CI 0.48–2.09) | |
| AKI | 1.1 (CI 0.92–1.31) | |
| MINS | 1.63 (CI 0.84–3.16) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Safety
- No drug infiltrations requiring treatment were reported in either group
Original publication
Norepinephrine versus phenylephrine for treating hypotension during general anaesthesia in adult patients undergoing major noncardiac surgery: a multicentre, open-label, cluster-randomised, crossover, feasibility, and pilot trial. Br J Anaesth. Published 14 March 2023. doi:10.
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