Why the study?
Does 35 µg/kg/h phenylephrine infusion compared to 25 µg/kg/h prevent hypotension and maintain haemodynamic stability in elderly patients undergoing femur fracture fixation under spinal anaesthesia?
Population
60 elderly patients older than 60 years, ASA class I and II, undergoing femur fracture fixation surgery…
Comparison
Phenylephrine infusion at 35 µg/kg/h vs Phenylephrine infusion at 25 µg/kg/h
Design
RCT, White and black cards randomly allocated patients, double-blind
Key result
High-dose phenylephrine infusion (35µg/kg/h) caused significantly more bradycardia (p=0.02) and reactive hypertension (p=0.03) than a 25µg/kg/h dose during spinal anaesthesia in elderly patients.
Authors
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Lower phenylephrine doses may reduce bradycardia and hypertension risk in elderly spinal anesthesia; extends sparse RCT dose data without practice change.
RCT (n=60)
Double-blind
White and black cards
Does 35 µg/kg/h phenylephrine infusion compared to 25 µg/kg/h prevent hypotension and maintain haemodynamic stability in elderly patients undergoing femur fracture fixation under spinal anaesthesia?
p-value: p=0.02 and 0.03
High-dose phenylephrine infusion (35 µg/kg/h) does not assure haemodynamic stability and increases the risk of bradycardia and reactive hypertension compared to 25 µg/kg/h in elderly patients undergoing spinal anaesthesia.
Golmohammadi et al. (2024) conducted an RCT in Femur fracture fixation surgery under spinal anaesthesia (n=60). Phenylephrine infusion vs. 25µg/kg/h phenylephrine infusion was evaluated on Bradycardia and reactive hypertension (p=0.02 and 0.03). High-dose phenylephrine infusion (35µg/kg/h) caused significantly more bradycardia (p=0.02) and reactive hypertension (p=0.03) than a 25µg/kg/h dose during spinal anaesthesia in elderly patients.
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