Double blind randomised clinical trial to determine the effective bolus dose of norepinephrine in preventing spinal hypotension during caesarean delivery

This randomized double-blind clinical trial aims to determine the effective bolus dose of norepinephrine to prevent spinal hypotension during cesarean delivery, a common complication of spinal anesthesia. Norepinephrine, with its strong alpha agonist and mild beta agonist activity, offers better hemodynamic stability compared to ephedrine and phenylephrine. A total of 130 term parturients aged 20–45 years (ASA II) undergoing elective or emergency cesarean section at KIMS, Hubli, will be randomized into two groups to receive either 0.05 mcg per kg or 0.10 mcg per kg norepinephrine bolus followed by a fixed-rate infusion. Maternal blood pressure, heart rate, need for rescue drugs, and adverse effects such as bradycardia, nausea, and vomiting will be recorded. The primary outcome is the incidence of spinal hypotension, and secondary outcomes include severity of hypotension, hypertension episodes, rescue drug usage, and hemodynamic changes. Data will be analyzed using SPSS with significance at p less than 0.05.