Prospective study of continuous low-dose norepinephrine infusion during induction of anesthesia: effects on the stability of blood pressure and recovery quality in elderly patients undergoing robotic radical prostatectomy

前瞻性研究:在麻醉诱导期间持续低剂量去甲肾上腺素输注对接受机器人辅助根治性前列腺切除术的老年患者血压稳定性和恢复质量的影响

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Abstract

OBJECTIVE: To assess the effect of low-dose norepinephrine infusion on hemodynamic changes during anesthesia induction and its correlation with postoperative recovery in elderly patients undergoing robot-assisted radical prostatectomy. METHODS: A prospective observational study was conducted on 63 elderly patients divided into two groups: the norepinephrine group (NE group) receiving 2-5 μg/kg·h norepinephrine by injection pump during anesthesia induction, and the control group (C group) with regular anesthesia. Heart rate (HR) and invasive blood pressure (BP) were recorded at four time points: before induction, pre-intubation lowest value (T1), post-intubation (T2), and lowest BP between intubation and skin incision (T3). Postoperative recovery (QoR-15) was evaluated on Days 1 and 3. RESULTS: Statistically significant differences in systolic (SBP) and diastolic blood pressure (DBP) were observed between groups at T1 and T3 (P<0.05), but no significant differences in HR were found at any time point (P>0.05). The NE group had significantly higher SBP, DBP, and HR at T1 and T3 compared to the C group (P<0.05). Hemodynamic stability was significantly better in the NE group (P<0.05). No significant differences were seen in QoR-15 scores or postoperative hospital stay between groups (P>0.05), but the Barthel Index increased significantly in the NE group (P<0.05). CONCLUSIONS: Continuous low-dose norepinephrine infusion effectively reduced blood pressure and heart rate fluctuations during anesthesia induction. However, the study showed only a weak correlation between intraoperative hemodynamic changes and postoperative recovery.

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