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Research article
Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study
Tarek Ashoor
Ain Shams University
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Anesthesiology.
Background: Post-spinal anesthesia (PSA) hypotension in elderly patients is challenging. Correction of PSA hypotension by fluids either colloids or crystalloids or by vasoconstrictors pose the risk of volume overload or compromising cardiac conditions. Dexamethasone is used to treat conditions manifested by decrease of peripheral vascular resistance. The research team was the first to test the hypothesis of its role in preventing or decreasing the incidence of PSA hypotension.
Methods: 110 patients, aged 60 years or more were recruited to receive a single preoperative dose of dexamethasone 8 mg IVI in 100 ml normal saline (D group) (55 patients) 2 hours preoperatively, and 55 patients were given placebo (C group) in a randomized, double-blind trial. Variations in blood pressure and heart rate in addition to the needs of ephedrine and/or atropine following spinal anesthesia (SA) were recorded. SA was achieved using subarachnoid injection of 3 ml hyperbaric bupivacaine 0.5%.
Results: Demographic data and the quality of sensory and motor block were comparable between groups. At 5th, 10th minutes post SA; systolic, diastolic and mean arterial pressures were statistically significant higher in D group. At 20th minutes post SA; the obtained blood pressure readings and heart rate changes didn’t show any statistically significance between groups. The need for ephedrine and side effects were statistically significant lower in D group than C group.
Conclusion: Post-spinal anesthesia hypotension, nausea, vomiting and shivering in elderly patients were less common after receiving a single preoperative dose of dexamethasone 8 mg IVI than control.
Keywords
Anesthesia, subarachnoid, Geriatric, Hemodynamics, Dexamethasone
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CURRENT STATUS: Published
Version 3
Posted 12 Jan, 2021
Published
On 11 Jan, 2021
No community comments so far
Editorial decision: Accept
On 30 Dec, 2020
Editor assigned
On 28 Dec, 2020
Submission checks complete
On 28 Dec, 2020
Editor invited
On 28 Dec, 2020
Editor assigned
On 19 Dec, 2020
Submission checks complete
On 19 Dec, 2020
Editor invited
On 19 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 05 Dec, 2020
Review #3 received
Received 21 Nov, 2020
Review #2 received
Received 16 Nov, 2020
Reviewer #3 agreed
On 04 Nov, 2020
Reviewer #2 agreed
On 30 Oct, 2020
Reviewers invited
Invitations sent on 28 Oct, 2020
Reviewer #1 agreed
On 28 Oct, 2020
Review #1 received
Received 28 Oct, 2020
Editor assigned
On 26 Oct, 2020
Submission checks complete
On 25 Oct, 2020
Editor invited
On 25 Oct, 2020
No comments provided
Editorial decision: Major revision
On 04 Oct, 2020
Review #1 received
Received 01 Oct, 2020
Review #3 received
Received 26 Sep, 2020
Review #2 received
Received 26 Sep, 2020
Review #5 received
Received 16 Sep, 2020
Reviewer #5 agreed
On 14 Sep, 2020
Review #4 received
Received 14 Sep, 2020
Reviewer #4 agreed
On 13 Sep, 2020
Reviewer #3 agreed
On 12 Sep, 2020
Reviewer #2 agreed
On 11 Sep, 2020
Reviewers invited
Invitations sent on 10 Sep, 2020
Reviewer #1 agreed
On 10 Sep, 2020
Editor assigned
On 27 Aug, 2020
Submission checks complete
On 26 Aug, 2020
Editor invited
On 26 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
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This preprint is under consideration at BMC Anesthesiology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study
Tarek Ashoor
Ain Shams University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 12 Jan, 2021
Published
On 11 Jan, 2021
No community comments so far
Editorial decision: Accept
On 30 Dec, 2020
Editor assigned
On 28 Dec, 2020
Submission checks complete
On 28 Dec, 2020
Editor invited
On 28 Dec, 2020
Editor assigned
On 19 Dec, 2020
Submission checks complete
On 19 Dec, 2020
Editor invited
On 19 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 05 Dec, 2020
Review #3 received
Received 21 Nov, 2020
Review #2 received
Received 16 Nov, 2020
Reviewer #3 agreed
On 04 Nov, 2020
Reviewer #2 agreed
On 30 Oct, 2020
Reviewers invited
Invitations sent on 28 Oct, 2020
Reviewer #1 agreed
On 28 Oct, 2020
Review #1 received
Received 28 Oct, 2020
Editor assigned
On 26 Oct, 2020
Submission checks complete
On 25 Oct, 2020
Editor invited
On 25 Oct, 2020
No comments provided
Editorial decision: Major revision
On 04 Oct, 2020
Review #1 received
Received 01 Oct, 2020
Review #3 received
Received 26 Sep, 2020
Review #2 received
Received 26 Sep, 2020
Review #5 received
Received 16 Sep, 2020
Reviewer #5 agreed
On 14 Sep, 2020
Review #4 received
Received 14 Sep, 2020
Reviewer #4 agreed
On 13 Sep, 2020
Reviewer #3 agreed
On 12 Sep, 2020
Reviewer #2 agreed
On 11 Sep, 2020
Reviewers invited
Invitations sent on 10 Sep, 2020
Reviewer #1 agreed
On 10 Sep, 2020
Editor assigned
On 27 Aug, 2020
Submission checks complete
On 26 Aug, 2020
Editor invited
On 26 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Anesthesiology.
Background: Post-spinal anesthesia (PSA) hypotension in elderly patients is challenging. Correction of PSA hypotension by fluids either colloids or crystalloids or by vasoconstrictors pose the risk of volume overload or compromising cardiac conditions. Dexamethasone is used to treat conditions manifested by decrease of peripheral vascular resistance. The research team was the first to test the hypothesis of its role in preventing or decreasing the incidence of PSA hypotension.
Methods: 110 patients, aged 60 years or more were recruited to receive a single preoperative dose of dexamethasone 8 mg IVI in 100 ml normal saline (D group) (55 patients) 2 hours preoperatively, and 55 patients were given placebo (C group) in a randomized, double-blind trial. Variations in blood pressure and heart rate in addition to the needs of ephedrine and/or atropine following spinal anesthesia (SA) were recorded. SA was achieved using subarachnoid injection of 3 ml hyperbaric bupivacaine 0.5%.
Results: Demographic data and the quality of sensory and motor block were comparable between groups. At 5th, 10th minutes post SA; systolic, diastolic and mean arterial pressures were statistically significant higher in D group. At 20th minutes post SA; the obtained blood pressure readings and heart rate changes didn’t show any statistically significance between groups. The need for ephedrine and side effects were statistically significant lower in D group than C group.
Conclusion: Post-spinal anesthesia hypotension, nausea, vomiting and shivering in elderly patients were less common after receiving a single preoperative dose of dexamethasone 8 mg IVI than control.
Figure 1
Figure 2
Figure 3
Figure 4