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Background <p>The use of a fluid co-load has been shown to enhance hemodynamic stability and diminish the occurrence of hypotension after spinal anesthesia when paired with prophylactic norepinephrine. This research aimed to identify the effective dosages (ED<sub>90</sub> and ED<sub>50</sub>) of prophylactic norepinephrine boluses, in conjunction with a crystalloid co-load, for the prevention of hypotension after spinal anesthesia in cesarean delivery patients.</p> Methods <p>Patients were administered crystalloid co-loads at a dosage of 10 mL/kg, in addition to preventive norepinephrine dosages direct following spinal anesthesia administration. The dosages of norepinephrine were established employing the up-and-down sequential allocation technique, starting with 8&#xa0;µg and progressively rising by 1&#xa0;µg increments. The primary objective was to detect the effective dosage (ED<sub>90</sub> and ED<sub>50</sub>) of norepinephrine necessary to avoid hypotension following spinal anesthesia.</p> Results <p>The ED<sub>90</sub> for a single norepinephrine bolus, in combination with a crystalloid co-load, was calculated to be 5.35&#xa0;µg (95% CI: 4.75 to 7.13). The ED<sub>50</sub> was determined to be 4.05&#xa0;µg (95% CI: 3.68 to 4.46) using the up-and-down method and 3.926&#xa0;µg (95% CI: 3.362 to 4.422) through the probit regression model.</p> Conclusion <p>A prophylactic norepinephrine bolus of 5.35&#xa0;µg, administered with a crystalloid co-load, effectively prevents hypotension following the spinal anesthesia in cesarean delivery patients.</p>

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Up-and-down determination of prophylactic norepinephrine boluses combined with crystalloid co-load for preventing post-spinal anesthesia hypotension during cesarean section

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月25日

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  • Chengfei Xu,
  • Peipei Zhang,
  • Chunying Dai,
  • Jingjun Zhang,
  • Honghao Wu,
  • Qianying Liu,
  • Zhiqiang Zhang,
  • Fengwei Yin,
  • Huadong Ni,
  • Liang Cheng

摘要

Background

The use of a fluid co-load has been shown to enhance hemodynamic stability and diminish the occurrence of hypotension after spinal anesthesia when paired with prophylactic norepinephrine. This research aimed to identify the effective dosages (ED90 and ED50) of prophylactic norepinephrine boluses, in conjunction with a crystalloid co-load, for the prevention of hypotension after spinal anesthesia in cesarean delivery patients.

Methods

Patients were administered crystalloid co-loads at a dosage of 10 mL/kg, in addition to preventive norepinephrine dosages direct following spinal anesthesia administration. The dosages of norepinephrine were established employing the up-and-down sequential allocation technique, starting with 8 µg and progressively rising by 1 µg increments. The primary objective was to detect the effective dosage (ED90 and ED50) of norepinephrine necessary to avoid hypotension following spinal anesthesia.

Results

The ED90 for a single norepinephrine bolus, in combination with a crystalloid co-load, was calculated to be 5.35 µg (95% CI: 4.75 to 7.13). The ED50 was determined to be 4.05 µg (95% CI: 3.68 to 4.46) using the up-and-down method and 3.926 µg (95% CI: 3.362 to 4.422) through the probit regression model.

Conclusion

A prophylactic norepinephrine bolus of 5.35 µg, administered with a crystalloid co-load, effectively prevents hypotension following the spinal anesthesia in cesarean delivery patients.