Evaluation of the Early Use of Norepinephrine in Major Abdominal Surgery on Postoperative Organ Dysfunction (EPON)
Norepinephrine, Hypotension, Anesthesiology
About this trial
This is an interventional other trial for Norepinephrine focused on measuring norepinephrine, ephedrine, Hypotension, anesthesiology, major abdominal surgery, Clavien Dindo score
Eligibility Criteria
Inclusion Criteria:
- Patients scheduled for major abdominal surgery
- ASA 2 or more patients
- Adults> 50 years old
- Patients eligible for general anesthesia
Exclusion Criteria:
- Patients scheduled for will be excluded and excluded from the study:
- ASA 1
- Children and adults <or = 50 years old
- Urgent surgery
- Allergy to a product used in the study
- Severe untreated or uncontrolled high blood pressure despite taking medication
- Acute cardiovascular event, including acute or decompensated heart failure and acute coronary syndrome
- Chronic kidney disease with a glomerular filtration rate of less than 30 ml / min / 1.73 m2 or requiring renal replacement treatment in the event of end-stage renal failure
- Preoperative sepsis
- Circulatory shock
- Preoperative noradrenaline infusion before entering the study
- Surgical procedure under regional anesthesia (epidural and spinal anesthesia)
- No affiliation with the French health system
- Participation in another concurrent intervention study
- Refusal to participate
- Pregnant or lactating women
Sites / Locations
- CHU AmiensRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Control group
Test group
The first anesthetic post-induction hypotension will be managed by intravenous injection of ephedrine (dilution: 3 mg / ml) at a dose of 6 mg (i.e. 2 ml). Any subsequent hypotension will be treated with ephedrine until injection of a total dose of 30 mg. Thereafter, if a new arterial hypotension occurs, we will pass to the administration of noradrenaline in intravenous injection using an electric syringe pump, at the dilution of 0.016 mg / ml, posology adapted to the objectives. blood pressure.
Immediately use of norepinephrine by intravenous injection using an electric syringe pump, at a dilution of 0.016 mg / ml, at the time of anesthetic induction and without waiting the 1st possible arterial hypotension. Noradrenaline will be started at a dose of 0.48 mg / h and then adapted according to the blood pressure objectives.