An interventional study of Normal Saline and Ephedrine in Postinduction Hypotension, sponsored by Cairo University. Recruiting at 1 site in Egypt. Open to participants aged 50 Years and older. Per ClinicalTrials.gov, last updated 2026-08-06.
Sponsored by Cairo University · Not applicable, Interventional, and Prevention
The aim of this work is to assess the efficacy of intermittent ephedrine boluses in prophylaxis against postinduction hypotension in high-risk patients undergoing major abdominal surgery, compared to standard care.
Fluid responders (≥20% rise in perfusion index on passive leg raising) will receive 500-mL Ringer's boluses (up to 1500 mL). Anesthesia will be induced with fentanyl/propofol, intubated after neuromuscular blockade, and maintained with isoflurane (1.2% end-tidal). Study drug will be given at induction and every 5 minutes for 20 minutes, withheld if MAP ≥80 mmHg or a recent vasopressor dose. Hypotension (MAP \<65 mmHg) will be treated with 0.1 mg/kg ephedrine boluses (max 9 mg single). Post-incision care follows anesthetist discretion.
Cairo University is the lead sponsor of 4,780 studies on the registry; 1,427 are open to participants now.
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Exclusion Criteria:
Normal Saline boluses
Drug: Normal Saline
ephedrine boluses
Drug: Ephedrine
four 10-mL syringes of normal saline, The patient will receive the first dose of the intervention with induction (0.1 ml/kg). After induction of anesthesia, the study drug will be given every 5 min for 20 min and will be withheld if MAP was ≥80 mmHg or if any vasopressor is given within 2 min of the current scheduled dose
four 10-mL syringes of ephedrine 1 mg/mL. The patient will receive the first dose of the intervention with induction (0.1 ml/kg). After induction of anesthesia, the study drug will be given every 5 min for 20 min and will be withheld if MAP was ≥80 mmHg or if any vasopressor is given within 2 min of the current scheduled dose.
incidence of postinduction hypotension
mean arterial pressure \< 65 mmHg
Time frame: from induction of anesthesia until 20 minutes after induction
area under mean arterial pressure of 65 mmHg
Time frame: from induction of anesthesia until 20 minutes after induction
Plan to share: No — data related to this protocol are available from principle investigator upon reasonable request
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Cairo University