Effect of sitting time on the vasopressor requirement in elderly patients after spinal anesthesia: A randomized controlled study

Abstract

ABSTRACT Background Neuraxial anesthesia appears to be a highly recommended, well-accepted technique for minimizing perioperative adverse effects in elderly patients. This research was designed to compare the impact of sitting for one, three, and 5 min on ephedrine consumption following spinal anesthesia in the elderly. Methods This randomized, controlled, double-blinded trial was conducted on 66 patients above 65 years undergoing surgeries under spinal anesthesia. Patients were randomly assigned to three equal groups. Patients received spinal anesthesia and then sat before they began to lie down for 1 min in the sitting-1 group, 3 min in the sitting-3 group, and 5 min in the sitting-5 group. Results The most reduction of mean arterial blood pressure (MAP) is in the Sitting-1 group, followed by the Sitting-3 group, and finally, the Sitting-5 group (p < 0.05). The most needed ephedrine was in the sitting-1 group (10 patients), followed by the sitting-3 (6 patients) and then the sitting-5 group (one patient) (p < 0.05). The sensory level was significantly higher in the sitting-1 group, followed by the sitting-3 and then sitting-5 group (p < 0.001). Conclusions Sitting for 5 min after spinal anesthesia in elderly patients decreases the ephedrine requirement and maintains adequate sensory block for surgery.