Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study
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.
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Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study
Posted 12 Jan, 2021
On 11 Jan, 2021
On 30 Dec, 2020
On 28 Dec, 2020
On 28 Dec, 2020
On 28 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
On 19 Dec, 2020
On 05 Dec, 2020
Received 21 Nov, 2020
Received 16 Nov, 2020
On 04 Nov, 2020
On 30 Oct, 2020
Invitations sent on 28 Oct, 2020
On 28 Oct, 2020
Received 28 Oct, 2020
On 26 Oct, 2020
On 25 Oct, 2020
On 25 Oct, 2020
On 04 Oct, 2020
Received 01 Oct, 2020
Received 26 Sep, 2020
Received 26 Sep, 2020
Received 16 Sep, 2020
On 14 Sep, 2020
Received 14 Sep, 2020
On 13 Sep, 2020
On 12 Sep, 2020
On 11 Sep, 2020
Invitations sent on 10 Sep, 2020
On 10 Sep, 2020
On 27 Aug, 2020
On 26 Aug, 2020
On 26 Aug, 2020
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