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Phase 2 N=66 Randomized Quadruple-blind Basic Science

The Prevention of Hypotension After Epidural Analgesia After Major Surgery

Hypotension · Pain

Enrolled (actual)
66
Serious AEs
0.0%
Results posted
Jun 2025
Primary outcome: Primary: Changes Between the 3 Groups Assessed by Blood Pressure Measurement — 5; 2; 3; 10 Participants — p=0.165

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Ropivacaine (Drug); Epinephrine (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
University of Florida
Primary completion
Oct 2017

Outcome Measures

OutcomeResultp-value
PRIMARY
Changes Between the 3 Groups Assessed by Blood Pressure Measurement
5; 2; 3; 10; 14; 13 0.165
SECONDARY
Changes Between the 3 Groups Assessed by the Spread of Local Anesthetic (Block) Effect
8; 11; 9; 10; 9; 7 0.06
SECONDARY
Changes Between the 3 Groups Assessed by Ambulation After Surgery
125.5; 90.2; 139.1 0.551
SECONDARY
Changes Between the 3 Groups Assessed by Opioid Usage
27.2; 40.4; 14.9; 41.9; 65.1; 28.3 0.349
SECONDARY
Changes Between the 3 Groups Assessed by Opioid-related Side Effects
1; 5; 1; 5; 8; 9 0.18
SECONDARY
Changes Between the 3 Groups Assessed by Fluid Balance
164; 305; 315; 2428; 1300; 1843
SECONDARY
Changes Between the 3 Groups Assessed by Length of Hospitalization
4; 2; 2
SECONDARY
Changes Between the 3 Groups Assessed by Days to Return to Oral Intake Status
1; 1; 1
SECONDARY
Changes Between the 3 Groups Continously Measured Cardiovascular Outcomes - Blood Pressure
-9.6; -5.0; -4.5; -0.3; -6.1; -8.2 0.524
SECONDARY
Differences Between the 3 Groups Assessed by Pain
3.5; 2.5; 4.3; 4.4; 3.9; 3.9 0.231
SECONDARY
Changes Between the 3 Groups Continously Measured Cardiovascular Outcomes - Respiratory Rate
-10.2; -4.2; -3.6 0.016 sig
SECONDARY
Changes Between the 3 Groups Continously Measured Cardiovascular Outcomes - Heart Rate
17.3; -2.1; 0.9 0.055
SECONDARY
Changes Between the 3 Groups Continously Measured Cardiovascular Outcomes - Oxygen Saturation
11.5; 1.8; 0.3 0.567

Summary

Epidural analgesia via continuous epidurally infused local anesthetic agent (LA) is widely and very successfully used routinely for perioperative pain control in patients undergoing major orthopedic and abdominal surgery since 1928. The choice currently depends on the preference of the APS physician in charge of the case. A frequent unwanted side effect of epidural block is hypotension due to the epidurally injected LA blocking the sympathetic nerves and thus the patient's response to hypotension, which is usually due to hypovolemia and/or an unopposed parasympathetic (via the vagus nerve) nervous system. The purpose of this research study is to see if adding epinephrine, to the epidural anesthetic will decrease possible side effects, such as low blood pressure, and lead to a better effect of the epidural anesthetic.

Eligibility Criteria

Inclusion Criteria

  • undergoing epidural analgesia to treat perioperative pain associated with major surgery
  • undergoing major thoracic surgery
  • undergoing major abdominal surgery
  • undergoing major orthopaedic surgery

Exclusion Criteria

  • sepsis
  • acute trauma
  • coagulopathy
  • preoperative hemodynamic instability
  • symptomatic coronary artery disease
  • patients from the ICU whose tracheas were intubated for any cause
  • allergies to medications in the protocol
  • primary or secondary block failure
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02722746). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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