Cafedrin/Theodrenalin (Akrinor®) Versus Ephedrine for Treatment of Hypotension in the Peri-operative Phase in Inpatient Setting

Inclusion Criteria:

• Inpatients, who received IV treatment (bolus administration) withcafedrine/theodrenaline or ephedrine (Ephedrin Meduna) due to an acute arterialhypotension
• Consent to use of data is available
• Patient under careful blood pressure and pulse monitoring (at least 2 minutesmeasuring interval (BP/HR) and/or at least 7 measurements within the first 15 minutesafter the first application of cafedrine/theodrenaline or ephedrine) Cohort A:
• Treatment of hypotension in < 100 mm Hg syst. and/or drop in blood pressure > 20%syst. compared to preoperative base value (syst.)
• Patients ≥ 50 years old
• Pre-existing comorbidities (ASA classification 2-4)
• Elective surgery
• General anaesthesia with propofol/fentanyl ≥ 0.2 mg (or equivalent) Cohort B:
• Treatment of hypotension in < 100 mm Hg syst. and/or drop in blood pressure > 10%syst. compared to preoperative base value (syst.)
• Patients ≥ 18 years old
• Caesarean section under spinal anaesthesia

Exclusion Criteria:

• Contraindication to the use of cafedrine/theodrenaline or ephedrine (Ephedrin Meduna)in accordance with current German specialist information
• Hypersensitivity to any product ingredient
• Hypertensive blood pressure readings
• Mitral stenosis
• Narrow-angle glaucoma
• Hyperthyroidism
• Pheochromocytoma
• Prostatic adenoma with urinary retention
• Bronchial asthmatics with sulphite sensitivity
• Hyper-excitability
• Arteriosclerosis
• Aneurysm
• Treatment with other indirect sympathomimetic drugs (Example:phenylpropanolamine, phenylephrine, pseudoephedrine or methylphenidate)
• Use of Monoamine oxidase (MAO) inhibitors (including within the last two weeks)
• Prophylactic administration of cafedrine/theodrenaline or ephedrine or otheranti-hypertensives
• Sepsis, septic shock or systemic inflammatory response syndrome (SIRS) Cohort A:

• Intra-cranial surgery or heart surgery Cohort B:

• High-risk pregnancy (emergency Caesarean, severe infantile malformation)
• Multiple pregnancy
• Amniotic infection syndrome