Dexamethasone Blunts Post-Spinal Hypotension in Geriatric Patients Undergoing Orthopedic Surgery: A Double Blind, Placebo-Controlled Study

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Abstract Background. Post-spinal hypotension in elderly is challenging, correction 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; we were the first to test the hypothesis of its role in preventing or decreasing the incidence of post-spinal hypotension.Methods. 110 patients aged 60 years or more were recruited in the study, 55 in the Dexamethasone group (D group) were given 8 mg Dexamethasone 2 hours preoperatively, and 55 were given placebo (C group).Variations in blood pressure and heart rate and need of vasoconstrictors and/or atropine following spinal anesthesia (SA) was done. SA was done by subarachnoid injection of 3 ml of hyperbaric bupivacaine.Results. Demographic data and the quality of sensory and motor block were comparable between groups. At 5, 10 minutes; systolic, diastolic and, mean arterial pressures were significantly higher in group D. At 20 minutes readings were non significant between groups. Heart rate changes didn’t show any significance. Need for ephedrine was less in group D, side effects were less in the D group. Conclusion. Dexamethasone may attenuate post-spinal hypotension in elderly, with a favorable response against nausea, vomiting and shivering that associate spinal anesthesia.

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