Perioperative medicine & outcomes
Phenylephrine Vs. Norepinephrine on the Renin–Angiotensin–Aldosterone System and Postoperative Complications in Acute Abdomen Emergency Surgery: A Randomized Controlled Trial
Authors' conclusion
PE and NE exert similar effects on RAAS components and postoperative complications. A higher plasma renin level before surgery is associated with greater vasopressor requirement and a higher incidence of postoperative complications.
Study context
- Population
- Adults (≥18 years) undergoing emergency acute abdominal surgery under GA
- Participants
- 156 adults
- Comparison
- Phenylephrine (PE) vs norepinephrine (NE)
Methodological detailssingle-centre
- Single-centre
Primary result
As reported in the abstract
Plasma renin change, immediate postoperative period · immediate postoperative period
| Group | Value | p |
|---|---|---|
| NE | median difference 21 (IQR 5–51) μIU/mL | p = 0.020 |
| PE | median difference 7 (IQR −1–33) μIU/mL | p = 0.336 |
Value
NEmedian difference 21 (IQR 5–51) μIU/mL
PEmedian difference 7 (IQR −1–33) μIU/mL
p
NEp = 0.020
PEp = 0.336
Further findings
Plasma renin change, immediate postoperative period
- Increase vs baseline significant in NE, not in PE
Plasma renin, angiotensin II and aldosterone · 24 hours postoperation
- Plasma renin significantly decreased and angiotensin II and aldosterone reduced in both groups at 24 h postoperation
Preoperative plasma renin (upper quartile)
- Upper quartile of preoperative plasma renin associated with higher vasopressor requirements and higher acute kidney injury (AKI) incidence
30-day mortality
- No significant difference between the groups in 30-day mortality rate
- RR: 1.00 [95% CI, 0.44-2.27], p = 1.000
Safety
AKI incidence
- No significant difference between the groups in AKI incidence
- RR: 1.50 [95% CI, 0.65-3.47], p = 0.569
Myocardial injury
- No significant difference between the groups in myocardial injury
- RR: 1.11 [95% CI, 0.64-1.93], p = 0.497
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Phenylephrine Vs. Norepinephrine on the Renin–Angiotensin–Aldosterone System and Postoperative Complications in Acute Abdomen Emergency Surgery: A Randomized Controlled Trial. Crit Care Med. Published 21 October 2025. doi:10.
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