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Postinduction HypotensionINDUCT-MultiNCT07538388

Continuous Versus Bolus Norepinephrine Administration to Treat Postinduction Hypotension

A study testing Continuous Norepinephrine Administration in people with Postinduction Hypotension, run by Universitätsklinikum Hamburg-Eppendorf at 4 sites in Germany.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

INDUCT-Multi is a multicenter randomized trial investigating whether continuous, compared to bolus, administration of norepinephrine during induction of general anesthesia reduces postinduction hypotension in high-risk non-cardiac surgery patients. Read more about this study

Who is it for?
Ages 45 years and older
Conditions the study is for
Postinduction Hypotension
What is being tested?
Continuous Norepinephrine Administration
Could I receive a placebo?
No, everyone receives an active treatment
How many people
446 participants
Where
4 sitesGermany
Study dates
7 May 2026to Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 45 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • We will include consenting patients ≥45 years scheduled for elective non-cardiac surgery under general anesthesia with planned continuous intra-arterial blood pressure monitoring with a radial arterial catheter and with at least two of the following risk criteria for developing acute kidney injury:
  • Age ≥65 years
  • ASA physical status III or IV
  • Chronic arterial hypertension
  • Diabetes mellitus requiring medication
  • Intra-abdominal surgery
  • Preoperative renal insufficiency (serum creatinine ≥1.2 mg/dL)

Who cannot join

  • Pregnancy
  • Cardiac arrhythmia
  • History of intracranial hemorrhage or intracranial aneurysm
  • Clinical indication for continuous norepinephrine infusion during induction of general anesthesia (e.g., severe aortic valve stenosis, coronary artery disease, or heart failure)
  • Patients who are unable to understand, read, and provide informed consent in German

Trial locations and contacts

4 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Kristen K Thomsen, MD contact

+4940741070215

kr.thomsen@uke.de

Germany4 sites, 4 recruiting
  • Department of Anesthesiology and Intensive Care Medicine, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin

    Berlin

    Sascha Treskatsch, MD, +49 30 450 551 522, sascha.treskatsch@charite.de

    Not yet recruiting
  • Department of Anesthesiology, University Hospital Duesseldorf, Heinrich Heine University Duesseldorf

    Düsseldorf

    Sebastian Roth, MD, +49 211 81 16253, Sebastian.Roth@med.uni-duesseldorf.de

    Recruiting
  • Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf

    Hamburg

    Kristen K Thomsen, MD, +4940741070215, kr.thomsen@uke.de

    Recruiting
  • Department of Anaesthesiology, University Hospital LMU Munich

    München

    Agnes Meidert, MD, +49 89 440081065, Agnes.meidert@med.uni-muenchen.de

    Recruiting

Other trials in Germany

About this study

Official title: Continuous Versus Bolus Norepinephrine Administration to Treat Postinduction Hypotension in High-Risk Non-Cardiac Surgery Patients - The Multicenter INDUCT Trial (INDUCT-Multi)

INDUCT-Multi is a multicenter randomized trial investigating whether continuous, compared to bolus, administration of norepinephrine during induction of general anesthesia reduces postinduction hypotension in high-risk non-cardiac surgery patients.

Read the detailed description

Hypotension after induction of general anesthesia, referred to as postinduction hypotension, is common in patients having non-cardiac surgery and is associated with acute kidney injury. Risk factors for postinduction hypotension include older age, higher American Society of Anesthesiologists physical status, chronic arterial hypertension - and higher doses of vasodilating anesthetic drugs. It is reasonable to assume that careful anesthetic management can help maintain blood pressure stability and limit postinduction hypotension. Consistent with this assumption, continuous blood pressure monitoring with an arterial catheter during induction of general anesthesia helps clinicians reduce postinduction hypotension - and is thus recommended in non-cardiac surgery patients at risk for hypotension-related complications.

Besides continuous monitoring, anesthesiologists routinely give vasopressors - such as norepinephrine - to maintain blood pressure. Norepinephrine is a fast acting vasopressor with a short half-life and is usually given as repeated manual boluses during induction of general anesthesia. Given as a bolus, it effectively and rapidly increases blood pressure. However, boluses need to be frequently repeated and well-timed to ensure blood pressure stability.

In a single-center randomized trial, we demonstrated that continuous - compared to bolus - administration of norepinephrine during induction of general anesthesia helps maintain blood pressure stability in high-risk non cardiac surgery patients. We now aim to test the hypothesis that continuous - compared to bolus - administration of norepinephrine during induction of general anesthesia reduces postinduction hypotension in high-risk non-cardiac surgery patients who have continuous blood pressure monitoring with an arterial catheter.

Being tested
Continuous Norepinephrine Administration
Keywords
postinduction hypotension, non-cardiac surgery, norepinephrine, bolus, hypotension, continuous
Medical subject headings
Hypotension

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Continuous Norepinephrine AdministrationProcedure or surgery

    In patients assigned to continuous administration of norepinephrine, a syringe infusion pump will be prepared and connected to a peripheral or central venous catheter. The responsible anesthesiologist will start the norepinephrine infusion and adjust the infusion rate as necessary and may administer additional norepinephrine boluses via the syringe infusion pump if required.

Study groups in NCT07538388
Study groupRoleWhat they receive
Continuous Norepinephrine AdministrationExperimentalIn patients assigned to continuous norepinephrine administration, norepinephrine will be administered continuously via a syringe infusion pump.
Receives: Procedure: Continuous Norepinephrine Administration
Bolus Norepinephrine AdministrationNo interventionIn patients assigned to manual bolus norepinephrine administration, norepinephrine will be given manually in bolus doses.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Area under a mean arterial pressure (MAP) of 65 mmHg (mmHg x min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

Secondary outcomes (32)
  1. Area under a MAP of 60 mmHg (mmHg x min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  2. Area under a MAP of 50 mmHg (mmHg x min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  3. Area under a MAP of 40 mmHg (mmHg x min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  4. Area above a MAP of 100 mmHg (mmHg x min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  5. Area above a MAP of 110 mmHg (mmHg x min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  6. Area above a MAP of 120 mmHg (mmHg x min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  7. Area above a MAP of 140 mmHg (mmHg x min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  8. Duration of a MAP <65 mmHg (min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  9. Duration of a MAP <60 mmHg (min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  10. Duration of a MAP <50 mmHg (min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  11. Duration of a MAP <40 mmHg (min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  12. Duration of a MAP >100 mmHg (min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  13. Duration of a MAP >110 mmHg (min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  14. Duration of a MAP >120 mmHg (min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  15. Duration of a MAP >140 mmHg (min)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  16. Absolute (n) and relative (%) number of patients with any MAP measurement <65 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  17. Absolute (n) and relative (%) number of patients with any MAP measurement <60 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  18. Absolute (n) and relative (%) number of patients with any MAP measurement <50 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  19. Absolute (n) and relative (%) number of patients with any MAP measurement <40 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  20. Absolute (n) and relative (%) number of patients with any MAP measurement >100 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  21. Absolute (n) and relative (%) number of patients with any MAP measurement >110 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  22. Absolute (n) and relative (%) number of patients with any MAP measurement >120 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  23. Absolute (n) and relative (%) number of patients with any MAP measurement >140 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  24. Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP <65 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  25. Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP <60 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  26. Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP <50 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  27. Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP <40 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  28. Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP >100 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  29. Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP >110 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  30. Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP >120 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  31. Absolute (n) and relative (%) number of patients with at least one 1-minute episode of a MAP >140 mmHg

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

  32. Cumulative dose of norepinephrine indexed to body weight (µg kg-1)

    Measured: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Apr 2026
  2. Study start7 May 2026
  3. Primary completionDec 2026 (estimated)
  4. Study completionDec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
446 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07538388
Sponsor's protocol ID
2025-101645-BO-ff
Other IDs
2025
Acronym
INDUCT-Multi
Status last verified
Jun 2026
First submitted
31 Mar 2026
Last updated
29 Jun 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Continuous Norepinephrine Administration in people with Postinduction Hypotension, run by Universitätsklinikum Hamburg-Eppendorf at 4 sites in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 29 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Kristen K Thomsen, MD (+4940741070215, kr.thomsen@uke.de), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Area under a mean arterial pressure (MAP) of 65 mmHg (mmHg x min) (time frame: First 15 minutes after starting induction of general anesthesia. The start of anesthetic induction is defined as the administration of propofol as hypnotic induction agent.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jun 2026.

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