Antar Sohila Samir, Metaweh Abdelaziz, Neamatallah Hamed, Abdelfattah Mahmoud, Abdelbaser Ibrahim, Awad Karim Ali
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Anaesth Crit Care Pain Med. 2025 Aug;44(4):101537. doi: 10.1016/j.accpm.2025.101537. Epub 2025 May 1.
This study aimed to investigate the efficacy of preoperative a caffeine tablet as prophylaxis against post-spinal hypotension in adult patients undergoing lower extremity orthopedic surgery.
Patients aged 18-70 years who underwent lower limb orthopedic surgery were enrolled. In the caffeine group, the patient ingested a 200 mg caffeine tablet. In the control group, the patient ingested a placebo. The primary outcome was the number of patients with one or more hypotensive episodes within the first hour of spinal anesthesia, which was defined as a decrease in mean arterial pressure (MAP) <60 mmHg or a >20% decrease in MAP from baseline. The secondary outcomes were the number of patients who received ephedrine and the amount of ephedrine per patient within the first hour of spinal anesthesia.
80 patients were randomized to the caffeine group (n = 40) and control group (n = 40). One patient in the caffeine group was lost to follow-up. The number of patients with one or more hypotensive episodes within the first hour of spinal anesthesia was significantly lower (p = 0.013) in the caffeine group (n = 6, 15.3%) than in the control group (n = 17, 42.5%). The number of patients who received ephedrine as well as the amount of ephedrine per patient within the first hour of spinal anesthesia were significantly lower in the caffeine group than in the control group.
The preoperative ingestion of a 200 mg caffeine tablet could decrease the number of patients with hypotensive episodes and ephedrine requirements within the first hour of spinal anesthesia.
Pan African Clinical Trial Registry, registration number PACTR202311786558285, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=26993.
本研究旨在探讨术前服用咖啡因片对接受下肢骨科手术的成年患者预防脊髓麻醉后低血压的疗效。
纳入年龄在18至70岁之间接受下肢骨科手术的患者。咖啡因组患者服用200毫克咖啡因片。对照组患者服用安慰剂。主要结局是脊髓麻醉后第一小时内发生一次或多次低血压发作的患者数量，低血压发作定义为平均动脉压（MAP）下降至<60 mmHg或MAP较基线下降>20%。次要结局是脊髓麻醉后第一小时内接受麻黄碱治疗的患者数量以及每位患者的麻黄碱用量。
80名患者被随机分为咖啡因组（n = 40）和对照组（n = 40）。咖啡因组有1名患者失访。脊髓麻醉后第一小时内发生一次或多次低血压发作的患者数量，咖啡因组（n = 6，15.3%）显著低于对照组（n = 17，42.5%）（p = 0.013）。脊髓麻醉后第一小时内，咖啡因组接受麻黄碱治疗的患者数量以及每位患者的麻黄碱用量均显著低于对照组。
术前服用200毫克咖啡因片可减少脊髓麻醉后第一小时内发生低血压发作的患者数量以及麻黄碱的需求量。
泛非临床试验注册中心，注册号PACTR202311786558285，https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=26993 。
