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NCT Number: NCT07719075

5 Versus 10 mcg Norepinephrine Bolus in Treatment of Postinduction and Early Intraoperative Hypotension in Emergency Abdominal Surgery

Postinduction hypotension is a frequent intraoperative complication, particularly in emergency abdominal surgery due to factors such as sepsis, hypovolemia, and limited preoperative cardiac assessment. Because it can lead to serious organ injury, prompt prevention and management are essential. Vasopressors, including ephedrine, phenylephrine, and norepinephrine, are commonly used, with NE gaining interest as an intraoperative bolus despite uncertainty about the optimal dose in general surgery population The aim of this study is to compare 5 mcg to 10 mcg norepinephrine bolus for treatment of postinduction hypotension and early intraoperative in emergency abdominal surgery.

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Key information

Conditions

Hypotension on Induction Cardiovascular Diseases Emergency Surgery Hypotension Norepinephrine Vascular Diseases

Age range

21 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Cairo University

Cairo, Cairo Governorate, Egypt

About this study

fluid assessment using stroke volume change after passive leg raising maneuver will be applied. If stroke volume increase >10%, 500-mL bolus of lactated ringer will be given. Passive leg raising will be repeated until the patient is non-responder or 1500 mL were infused.

intraoperatively, heart rate and blood pressure will be monitored at 2 min intervals until 30 min after skin incision.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adult patients, American Society of anesthesiologists (ASA) I-III undergoing emergency abdominal surgery

Exclusion criteria

  • Severe cardiac morbidities (impaired contractility with ejection fraction < 45%, heart block, arrhythmias, tight valvular lesions)
  • Patients on vasopressor infusion,
  • Pregnant or lactating women,
  • Allergy of any of the study drugs

Treatment and study plan

Norepinephrine 10 mcg

Drug

Norepinephrine dose of 10 mcg will be given if patient developed hypotension (mean arterial pressure <65 mmHg). The norepinephrine bolus (10 mcg) will be repeated if mean arterial pressure is not restored within 2 min. Norepinephrine infusion will be started if hypotension persisted after three boluses.

Norepinephrine 5 mcg

Drug

Norepinephrine dose of 5 mcg will be given if patient developed hypotension (mean arterial pressure <65 mmHg). The norepinephrine bolus (5 mcg) will be repeated if mean arterial pressure is not restored within 2 min. Norepinephrine infusion will be started if hypotension persisted after three boluses.

Primary outcomes

  1. Incidence of successfully managed hypotensive episode

    Time frame: from 0 min of induction of anesthesia until 30 min after skin incision

    mean arterial pressure >65 mmHg within 2 min of drug administration

Secondary outcomes

  1. Area under a mean arterial pressure of 65 mmHg

    Time frame: from 0 min of induction of anesthesia until 30 min after skin incision

    The area under a mean arterial pressure (MAP) of 65 mm Hg will be calculated by subtracting MAP measurements from 65 mm Hg, multiplying positive differences with the time difference (in minutes) between this MAP measurement and the consecutive MAP measurement, and summing the values

  2. Duration of MAP<65 mmHg

    Time frame: from 0 min after induction of anesthesia until 30 min after skin incision

    in minutes

  3. bradycardia

    Time frame: from 0 min after induction of anesthesia until 30 min after skin incision

    heart rate < 50 bpm following drug administration

  4. hypertension

    Time frame: from 0 min after induction of anesthesia until 30 min after skin incision

    systolic blood pressure >120% of baseline following drug administration

Study contacts

Contact information is provided by the study sponsor or research team.

Maha Mostafa, MD

CONTACT

[email protected]

+201000365115

Sponsors and collaborators

Lead sponsor

Cairo University

Other

Registry information

Official study title

Comparing 5 mcg and 10 mcg Norepinephrine Bolus in Treatment of Postinduction and Early Intraoperative Hypotension in Emergency Abdominal Surgery: a Randomized Controlled Trial

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jul 22, 2026
Registry last updated
Jul 22, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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