Prophylactic, Manually Titrable Variable Rate Norepinephrine Infusion for Prevention of Hypotension during Spinal Anesthesia for Cesarean Section: A Randomized, Double Blind, Controlled Study

Background and Aims: Norepinephrine is recently being investigated for mitigation of spinal-induced hypotension. Our study aimed at evaluating the role of manually titrated infusion of norepinephrine in preventing hypotension in patients undergoing lower segment cesarean section (LSCS) under subarachnoid block (SAB). Subjects and Methods: This prospective, randomized, double-blind, placebo-controlled trial was conducted in 140 parturients undergoing LSCS under SAB. Patients were randomly allocated to two groups: group A received an infusion of 5 μg/mL norepinephrine started at 30 mL/h (2.5 μg/min) immediately after SAB and manually adjusted within the range 0–60 mL/h (0–5 μg/min), according to the values of systolic blood pressure (SBP) until delivery; in group B, no prophylactic vasopressor was given, and bolus 1 mL norepinephrine (5 μg) was given whenever the SBP decreased to