Efficacy of Dexamethasone in Attenuation of Postinduction Hypotension in Geriatric Patients Undergoing General Anesthesia: A Randomized Controlled Trial

Abstract

Abstract Background Postinduction hypotension is a common problem that faces anesthesiologists on a daily basis, with incidence ranging from 25% to 67.5% when propofol is used as an induction agent. Post-induction Hypotension is even more common in the elder population because increase in age is an independent predictor of intraoperative hypotension as a result of the diminished cardiovascular reserves. Aim of the Work This study assessed the efficacy of dexamethasone to alleviate the drop in blood pressure after induction of anesthesia. All patients were informed of their participation in the study and written consents were taken. They were assessed preoperatively by careful history taking, full physical examination, and laboratory evaluation. Patients and Methods A Prospective randomized clinical study in Ain-Shams University hospitals, Cairo, Egypt form June 15, 2021 to October 15, 2021 on 100 randomly chosen patients aged ≥ 60 years, American Society of Anesthesiologists (ASA) class I or II who were scheduled for elective surgery in Ain Shams University Hospitals, after approval of the medical ethical committee. They were allocated in two groups of 50 patients each. Results The results of the study revealed that the Patients who received preoperative dexamethasone had a significantly less incidence of hypotension, nausea, vomiting and shivering. Accordingly, ephedrine and IV fluid boluses were less frequently needed. Conclusion A single 8 mg IV dexamethasone given two hours preoperatively was able to decrease the incidence of postinduction hypotension in geriatric patients undergoing general anesthesia, leading to decreased use of ephedrine and IV fluid boluses. In addition, a significantly fewer percentage of patients developed nausea, vomiting and shivering after surgery than those who didn’t receive the drug.