Efficacy of dexamethasone in attenuation of postinduction hypotension in geriatric patients undergoing general anesthesia: a randomized controlled trial

Document Type : Original Article

Authors

1 department of Anesthesia and Intensive Care, Faculty of Medicine, Ain-Shams University, Cairo, Egypt

2 Department of anaesthesia, Faculty of medicine, Ain-Shams University

Abstract

Background
Postinduction hypotension (PIH) in geriatric patients has deleterious effects. Avoidance of PIH in this group of patients should result in lower perioperative morbidity and mortality. Dexamethasone is known for its vasopressor enhancing effect. The efficacy of preoperative dexamethasone to avoid PIH in geriatric patients was tested in this study.
Results
Demographic data were comparable between both groups. The systolic blood pressure (SBP) readings at 1- and 2-minutes were lower in control (C) group (P < 0.001). The diastolic blood pressure (DBP) and the mean blood pressure (MBP) readings were lower in group C at 1 ,2, and 5 minutes (P < 0.001). The proportion of patients who suffered significant hypotension (primary outcome) was significantly higher in group C (P = 0.009). Patients in group C significantly needed IV fluids boluses, boluses of ephedrine, both ephedrine and IV fluids boluses more than patients in (dexamethasone (D) group) (P = 0.039, P = 0.009, P = 0.031, respectively).
Conclusions
A preemptive single dose of 8 mg dexamethasone attenuated the postinduction hypotension in geriatric patients scheduled for general anesthesia.

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