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Pharmacokinetic and Pharmacodynamic Modelling of Norepinephrine in Patients Under Target Controlled Infusions (TCI) for Anaesthesia (NOR-PHARM)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT03454204
Recruitment Status : Recruiting
First Posted : March 5, 2018
Last Update Posted : August 18, 2020
Information provided by (Responsible Party):
Assistance Publique - Hôpitaux de Paris

Brief Summary:
Currently, administration of norepinephrine diluted at 5 µg/ml bolus or continuous infusion is common during sympatholysis hypotension of TCI following the elimination of hypovolemia or anesthetic overdosage. Continued intravenous administration must meet hemodynamic goals within a narrow time frame. Depending on the intensity of hypotension the dosage is variable. It is adjusted in real time while it is excessive or insufficient at times. Therefore, the development of modeling should predict the kinetic and hemodynamic effects based on dosage and individual.

Condition or disease Intervention/treatment
Neurosurgery Intervention Other: Pharmacokinetic

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Study Type : Observational
Estimated Enrollment : 30 participants
Observational Model: Other
Time Perspective: Prospective
Official Title: Pharmacokinetic and Pharmacodynamic Modelling of Norepinephrine in Patients Under Target Controlled Infusions (TCI) for Anaesthesia : Plasma Concentration and "Site Effect"
Actual Study Start Date : June 27, 2018
Estimated Primary Completion Date : June 27, 2021
Estimated Study Completion Date : June 27, 2021

Resource links provided by the National Library of Medicine

Group/Cohort Intervention/treatment
Establish a pharmacokinetic relationship between plasma concentration and the effect of norepinephrine in patients under concentration-target intravenous anesthesia by identifying significant covariates during general anesthesia.
Other: Pharmacokinetic
Analysis of blood samples

Primary Outcome Measures :
  1. PLASMATIC DOSAGES [ Time Frame: 1 day ]
    Relationship between exposure and the effect (desired-effectiveness or undesirable-toxicity) of norepinephrine during hypotension induced by anaesthetic drugs in a pharmacokinetic model (PLASMATIC DOSAGES) and pharmacodynamic model (HEMODYNAMIC EFFECTS MODELISED)

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population
The study involves major patients who have benefited from intraoperative hemodynamic optimization with norepinephrine (as noradrenaline tartrate) for maintaining blood pressure under general anaesthesia in neurosurgery and interventional neuroradiology in adults.

Inclusion Criteria:

  • 1. Adult patient > 18 years of age with neurosurgery or neurological interventional radiology for whom invasive monitoring of blood pressure is indicated.
  • 2. Patient with persistent low blood pressure during the general anesthesia procedure (Fall > 30% of preoperative MAP registered after patient installation and/or MAP < 55 mmHg) and achieves the depth of anesthesia objective (BIS 40-50).

Exclusion Criteria:

  • 1. A patient on a continuous infusion of norepinephrine or other catecholamine initiated in another department or facility or whose start was not recorded or whose dosage changes were unknown.
  • 2. All causes of hypotension related to the patient's intervention or illness.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03454204

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Contact: Vallée Fabrice, MD +331 49 95 83 74
Contact: Dr Joaquim MATEO Joaquim, MD +33 1 49 95 83 74

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Service Anesthésie-Réanimation - Hôpital Lariboisière Recruiting
Paris, France, 75010
Contact: Fabrice Vallée, MD    +33 1 49 95 83 74   
Sponsors and Collaborators
Assistance Publique - Hôpitaux de Paris
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Principal Investigator: Vallée Fabrice, MD Assistance Publique - Hôpitaux de Paris
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Responsible Party: Assistance Publique - Hôpitaux de Paris Identifier: NCT03454204    
Other Study ID Numbers: K170902J
2017-A02671-52 ( Other Identifier: IDRCB )
First Posted: March 5, 2018    Key Record Dates
Last Update Posted: August 18, 2020
Last Verified: August 2020

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No