Effective dose of ephedrine for treatment of hypotension after induction of general anaesthesia in neonates and infants less than 6 months of age: a multicentre randomised, controlled, open label, dose escalation trial.


Journal

British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541

Informations de publication

Date de publication:
05 2023
Historique:
received: 19 07 2022
revised: 18 11 2022
accepted: 10 12 2022
medline: 14 4 2023
pubmed: 14 1 2023
entrez: 13 1 2023
Statut: ppublish

Résumé

The recommended dose of ephedrine in adults (0.1 mg kg We conducted a multicentre, prospective, randomised, open-label, controlled, dose-escalation trial. Subjects were randomised if presenting a >20% change from baseline in MAP. Six cohorts of 20 subjects each were enrolled. Ten subjects in the first cohort received 0.1 mg kg A total of 119 infants (25% females), with a mean age (standard deviation) of 2.7 (1.3) months, received their allocated dose of ephedrine. The optimal dose of ephedrine was 1.2 mg kg Doses of ephedrine much higher (∼10-fold) than those used in adults are necessary in neonates and infants for the treatment of hypotension after induction of general anaesthesia with sevoflurane. NCT02384876.

Sections du résumé

BACKGROUND
The recommended dose of ephedrine in adults (0.1 mg kg
METHODS
We conducted a multicentre, prospective, randomised, open-label, controlled, dose-escalation trial. Subjects were randomised if presenting a >20% change from baseline in MAP. Six cohorts of 20 subjects each were enrolled. Ten subjects in the first cohort received 0.1 mg kg
RESULTS
A total of 119 infants (25% females), with a mean age (standard deviation) of 2.7 (1.3) months, received their allocated dose of ephedrine. The optimal dose of ephedrine was 1.2 mg kg
CONCLUSIONS
Doses of ephedrine much higher (∼10-fold) than those used in adults are necessary in neonates and infants for the treatment of hypotension after induction of general anaesthesia with sevoflurane.
CLINICAL TRIAL REGISTRATION
NCT02384876.

Identifiants

pubmed: 36639328
pii: S0007-0912(22)00693-6
doi: 10.1016/j.bja.2022.12.006
pii:
doi:

Substances chimiques

Ephedrine GN83C131XS
Vasoconstrictor Agents 0
Sevoflurane 38LVP0K73A

Banques de données

ClinicalTrials.gov
['NCT02384876']

Types de publication

Randomized Controlled Trial Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

603-610

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2022 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Auteurs

Anne-Sara Szostek (AS)

Department of Paediatric Anaesthesia, Hospices Civils de Lyon, Bron, France.

Clarisse Saunier (C)

Department of Epidemiology, Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Bron, France.

Mad-Hélénie Elsensohn (MH)

Department of Biostatistics, Hospices Civils de Lyon, Université Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne, France.

Pierre Boucher (P)

Department of Paediatric Anaesthesia, Hospices Civils de Lyon, Bron, France.

Fanette Merquiol (F)

Department of Anaesthesia, University Hospital of Saint-Etienne, Saint-Etienne, France.

Adeline Gerst (A)

Department of Anaesthesia, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.

Aurélie Portefaix (A)

Department of Epidemiology, Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Bron, France; Department of Biostatistics, Hospices Civils de Lyon, Université Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne, France.

Dominique Chassard (D)

Department of Anaesthesia, Hospices Civils de Lyon, Université Lyon 1, Bron, France. Electronic address: dominique.chassard@chu-lyon.fr.

Mathilde De Queiroz Siqueira (M)

Department of Paediatric Anaesthesia, Hospices Civils de Lyon, Bron, France.

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Classifications MeSH