Association between intraoperative noradrenaline infusion and outcomes in elderly patients undergoing major oncologic surgeries: A retrospective propensity score-matched cohort study

Abstract

Background:Noradrenaline (NA) is commonly used intraoperatively to prevent fluid overload and maintain hemodynamic stability. Animal and clinical studies provided inconsistent results concerning the effect of NA on postoperative outcomes. As aging is accompanied with various diseases and has the high possibility of the risk for postoperative complications, we hypothesized that intraoperative NA infusion in elderly patients undergoing major oncologic surgeries might potentially exert adverse outcomes. Methods: In this retrospective propensity score-matched cohort study, elderly patients undergoing major oncologic surgeries were selected, 1837 receiving NA infusion during surgery, and 1072 not receiving NA. The propensity score matching was conducted with a 1:1 ratio and 1072 patients were included in each group. The primary outcomes were postoperative in-hospital mortality and complications. Results:Intraoperative NA administration reduced postoperative urinary tract infection (OR:0.124, 95% CI: 0.016-0.995), and had no effect on other postoperative complications and mortality, it reduced intraoperative crystalloid infusion (OR:0.999, 95% CI: 0.999-0.999), blood loss (OR: 0.998, 95% CI: 0.998-0.999), transfusion (OR:0.327, 95% CI: 0.218-0.490), but increased intraoperative lactate production (OR:1.354, 95% CI: 1.051-1.744), and hospital stay (OR:1.019, 95% CI: 1.008-1.029). Conclusions: Noradrenaline has little impact on postoperative complications and mortality in elderly patients undergoing major oncologic surgeries, and can be safely administered intraoperatively.