Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study
Abstract 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 conditio...
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-021-01232-w |
| _version_ | 1818430695578533888 |
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| author | Tarek M. Ashoor Noha S. Hussien Sherif G. Anis Ibrahim M. Esmat |
| author_facet | Tarek M. Ashoor Noha S. Hussien Sherif G. Anis Ibrahim M. Esmat |
| author_sort | Tarek M. Ashoor |
| collection | DOAJ |
| description | Abstract 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 One hundred ten 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 h 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. Registration number ClinicalTrials.gov Identifier: NCT 03664037 , Registered 17 September 2018 - Retrospectively registered, http://www.ClinicalTrial.gov |
| first_indexed | 2024-12-14T15:37:30Z |
| format | Article |
| id | doaj.art-278635b76eef402499f36dacc883e49d |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-14T15:37:30Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-278635b76eef402499f36dacc883e49d2022-12-21T22:55:41ZengBMCBMC Anesthesiology1471-22532021-01-012111910.1186/s12871-021-01232-wDexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled studyTarek M. Ashoor0Noha S. Hussien1Sherif G. Anis2Ibrahim M. Esmat3Department of Anesthesia and Intensive Care, Ain Shams UniversityDepartment of Anesthesia and Intensive Care, Faculty of Medicin, Ain Shamse UniversityDepartment of Anesthesia and Intensive Care, Faculty of Medicin, Ain Shamse UniversityDepartment of Anesthesia and Intensive Care, Faculty of Medicin, Ain Shamse UniversityAbstract 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 One hundred ten 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 h 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. Registration number ClinicalTrials.gov Identifier: NCT 03664037 , Registered 17 September 2018 - Retrospectively registered, http://www.ClinicalTrial.govhttps://doi.org/10.1186/s12871-021-01232-wAnesthesia, subarachnoidGeriatricHemodynamicsDexamethasone |
| spellingShingle | Tarek M. Ashoor Noha S. Hussien Sherif G. Anis Ibrahim M. Esmat Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study BMC Anesthesiology Anesthesia, subarachnoid Geriatric Hemodynamics Dexamethasone |
| title | Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study |
| title_full | Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study |
| title_fullStr | Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study |
| title_full_unstemmed | Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study |
| title_short | Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study |
| title_sort | dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery a double blind placebo controlled study |
| topic | Anesthesia, subarachnoid Geriatric Hemodynamics Dexamethasone |
| url | https://doi.org/10.1186/s12871-021-01232-w |
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