Evidence map›Paper›PMID 40744797›Full record

Trial reportBritish journal of anaesthesia2025

Continuous versus bolus norepinephrine administration and arterial blood pressure stability during induction of general anaesthesia in high-risk noncardiac surgery patients: a randomised trial.

Christina Vokuhl, Karim Kouz, Moritz Flick, Linda Krause, Alina Kröker, Parisa Moll-Khosrawi, Christian Zöllner, Daniel I Sessler, Bernd Saugel, Kristen K Thomsen

Registry-linked trialAbstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05997303 (Continuous Norepinephrine Administration and Blood Pressure Stability During Anesthetic Induction - A Randomized Controlled Trial), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05997303 nacompletednot on this map

Continuous Norepinephrine Administration and Blood Pressure Stability During Anesthetic Induction - A Randomized Controlled Trial

TypeinterventionalSponsorUniversitätsklinikum Hamburg-EppendorfRan2023 to 2024Enrolled72ConditionsBlood Pressure, Perioperative HypotensionArmsContinuous norepinephrine infusion via an infusion pump, Manual bolus norepinephrine administration
3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
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  4. Trial
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Christina VokuhlDepartment of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Karim KouzDepartment of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Outcomes Research Consortium®, Houston, TX, USA.
Moritz FlickDepartment of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Linda KrauseInstitute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Alina KrökerDepartment of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Parisa Moll-KhosrawiDepartment of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Christian ZöllnerDepartment of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Daniel I SesslerOutcomes Research Consortium®, Houston, TX, USA; Center for Outcomes Research and Department of Anesthesiology, UTHealth, Houston, TX, USA.
Bernd SaugelDepartment of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Outcomes Research Consortium®, Houston, TX, USA.
Kristen K ThomsenDepartment of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Outcomes Research Consortium®, Houston, TX, USA. Electronic address: science.thomsen@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypotension after induction of general anaesthesia is common in high-risk patients having noncardiac surgery. Anaesthesiologists often give manual boluses of vasopressors repeatedly to maintain blood pressure during induction of general anaesthesia, including the fast-acting vasopressor norepinephrine which has a short half-life. We tested the hypothesis that giving norepinephrine continuously during induction of general anaesthesia, compared with giving it as repeated manual boluses, improves blood pressure stability in high-risk noncardiac surgery patients.

methodsIn this single-centre trial, 72 participants undergoing noncardiac surgery were randomised to continuous norepinephrine infusion or manual bolus norepinephrine administration during induction of general anaesthesia. Blood pressure was monitored continuously with an arterial catheter. The primary endpoint was blood pressure stability, quantified as the generalised average real variability of mean arterial pressure within 15 min after starting induction of general anaesthesia.

resultsA total of 71 participants completed the study (mean [range] age: 66 [47-86] y; 48% female). The mean (standard deviation) generalised average real variability of mean arterial pressure was 19 (6) mm Hg min

conclusionsGiving norepinephrine continuously during induction of general anaesthesia, compared with giving it as repeated manual boluses, improved blood pressure stability in higher-risk individuals undergoing noncardiac surgery. CLINICAL

trial registrationNCT05997303.

Indexed as

Anesthesia, GeneralArterial PressureHypotensionNorepinephrineSurgical Procedures, OperativeVasoconstrictor AgentsAgedAged, 80 and overBlood PressureFemaleHumansInfusions, IntravenousMaleMiddle AgedNorepinephrineVasoconstrictor Agentsanaesthesia inductionarterial pressurecardiovascular dynamicsgeneral anaesthesiageneralised average real variabilityhaemodynamic monitoringvasopressor

Identifiers

PMID40744797
PMCPMC12674030

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.