Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study
| Autor: | Noha S. Hussien, Ibrahim M. Esmat, Sherif G. Anis, Tarek M. Ashoor |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Nausea Placebo-controlled study Hemodynamics Placebo Anesthesia Spinal Dexamethasone lcsh:RD78.3-87.3 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Anesthesia subarachnoid Double-Blind Method 030202 anesthesiology Heart rate medicine Humans Orthopedic Procedures Geriatric Assessment Glucocorticoids Aged business.industry Treatment Outcome Anesthesiology and Pain Medicine Blood pressure medicine.anatomical_structure lcsh:Anesthesiology Anesthesia Vascular resistance Vomiting Female Hypotension medicine.symptom business Geriatric Research Article |
| Zdroj: | BMC Anesthesiology BMC Anesthesiology, Vol 21, Iss 1, Pp 1-9 (2021) |
| ISSN: | 1471-2253 |
| Popis: | 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 |
| Databáze: | OpenAIRE |
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