Treatment of intraoperative hypotension with cafedrine/theodrenaline versus ephedrine
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L. Eberhart1 · G. Geldner2 · A. Kowark3 · T.-P. Zucker4 · S. Kreuer5 · M. Przemeck6 · S. Huljic7 · T. Koch1 · T. Keller8 · S. Weber8 · P. Kranke9 · the HYPOTENS study group 1
Department of Anesthesiology & Intensive Care, Philipps University Marburg, Marburg, Germany Clinic for Intensive Care, Emergency Medicine and Pain Therapy, Hospital Ludwigsburg, Ludwigsburg, Germany 3 Department of Anesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany 4 Department of Anesthesiology, Intensive Care and Pain Therapy, Academic Teaching Hospital Traunstein, Traunstein, Germany 5 Department of Anesthesiology, Intensive Care and Pain Therapy, University Hospital Saarland, Homburg, Germany 6 Department of Anesthesiology and Intensive Care, DIAKOVERE Annastift, Hannover, Germany 7 ratiopharm GmbH, Ulm, Germany 8 ACOMED Statistik, Leipzig, Germany 9 Department of Anesthesia and Critical Care, University Hospital Würzburg, Würzburg, Germany 2
Treatment of intraoperative hypotension with cafedrine/theodrenaline versus ephedrine A prospective, national, multicenter, noninterventional study—the HYPOTENS trial
Electronic supplementary material The online version of this article (https://doi. org/10.1007/s00101-020-00877-5) contains one further table and two figures. The article and additional material are available at www. springermedizin.de. Please enter the title of the article in the search field. You will find the additional material under “Ergänzende Inhalte” in the article.
Brief introduction to the topic Sympathomimetic drugs play an essential role in the treatment of hypotensive states [1, 2]. A number of pharmacotherapies are currently available, including phenylephrine, norepinephrine, cafedrine/theodrenaline (C/T) and ephedrine (E). While C/T has been widely used in Germany since 1963 [3, 4]. E is more commonly used internationally and was approved for use in Germany only in 2013 [5]. Both agents stimulate alpha- and beta-adrenoceptors, making them particularly suited for the treatment of hypotension caused by both cardiac depression and vasodilatation [1, 6].
Background Intraoperative hypotension (IOH) is a common side effect of anesthesia and is associated with perioperative morbidity and mortality [7, 8], making rapid
and precise recovery of blood pressure crucial. Restoring and maintaining optimal blood pressure has been shown to reduce organ damage [9]. So far, comparative clinical studies that investigated the combination of C/T and E for the treatment of hypotension are lacking and the optimal drug for the pharmacological treatment of IOH remains a subject of long-standing debate [10, 11].
All members of the HYPOTENS study group are listed in alphabetical order at the end of this article. Data sharing Qualified researchers may request access to patient-level data and related study documents, including the study protocol and the statistical analysis plan. Requests will be reviewed for scientific merit, product approval status, and conflictsofinterest. Patient-leveldatawillbedeidentified and study documents
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