Key result
Prophylactic intravenous atropine (0.6 mg) or ephedrine (12 mg) safely and effectively prevented spinal anesthesia-induced hypotension and bradycardia in elderly patients compared to placebo.
Why the study?
Does prophylactic IV atropine or ephedrine prevent spinal anesthesia-induced hypotension in elderly patients undergoing urological surgeries?
RCT (n=60)
Double-blind
randomized
Does prophylactic IV atropine or ephedrine prevent spinal anesthesia-induced hypotension in elderly patients undergoing urological surgeries?
Prophylactic IV atropine or ephedrine effectively prevents spinal anesthesia-induced hypotension and bradycardia in elderly patients.
Supports routine prophylaxis with atropine or ephedrine in elderly spinal anesthesia; extends RCT evidence to urological surgery patients.
Background: Spinal anesthesia induced hypotension is more common and hazardous in elderly, as they have decreased physiological reserve and compromised blood supply to various vital organs. Reversal of the blunted reflexes of tachycardia following hypotension in elderly with atropine or ephedrine may help in prevention of hypotension. Methodology: Present study is a prospective, randomized, double blind, controlled trial where sixty ASAPS I-II patients undergoing urological surgeries were assigned to receive either IV normal saline (placebo) or IV atropine 0.6 mg or IV ephedrine 12 mg one minute after induction of spinal anesthesia. Heart rate (HR), mean arterial pressure (MAP), requirement mephentermine and phenylephrine and side effects profile were studied were studied. Hemodynamic parameters were compared with baseline in each and among the groups. Results: The patients were comparable with demographic data, baseline hemodynamic parameters and duration of surgery. Compared to baseline, trend of mean HR and MAP significantly dropped in placebo in most of the times (p group (5%)]. Conclusion: Administration of intravenous atropine 0.6 mg or IV ephedrine (12 mg) one min after induction of spinal anesthesia in elderly patient is safe and effective in the prevention of spinal anesthesia induced hypotension and bradycardia, requirement of vasopressors decreased without clinically significant side effects.
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Roshana Amatya (2015) conducted an RCT in Spinal anesthesia induced hypotension (n=60). Atropine or Ephedrine vs. IV normal saline (placebo) was evaluated on Heart rate (HR), mean arterial pressure (MAP), requirement of mephentermine and phenylephrine, and side effects profile. Prophylactic intravenous atropine (0.6 mg) or ephedrine (12 mg) safely and effectively prevented spinal anesthesia-induced hypotension and bradycardia in elderly patients compared to placebo.
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