International Journal of Anesthesiology & Pain Medicine

Prophylactic use of Iv Atropine for Prevention of Spinal Anesthesia Induced Hypotension and Bradycardia in Elderly; a Randomized Controlled Trial

Background: Spinal anesthesia induced hypotension is common and hazardous in elderly patients. Reversal of the blunted reflexes of tachycardia following hypotension in elderly with atropine helps in prevention of spinal anesthesia induced hypotension in elderly.

Methodology: In this randomized, double-blind, controlled trial forty ASA PS I to II patients undergoing urological surgeries were assigned to receive either IV normal saline (placebo) or IV atropine 0.6 mg one minute after induction of spinal anesthesia. Heart rate (HR), mean arterial pressure (MAP), requirement mephentermine or phenylepherine and side effects profile were studied intra/postoperatively for 6 h.

Results: The patients were comparable with respect to demographic profile, baseline hemodynamic parameters and duration of surgery. Compared to baseline, mean HR and MAP significantly reduced in placebo group most of the study times (p<0.05). Comparing intra group, HR and MAP were also significantly decreased in placebo group. The incidence of hypotension was high in placebo (60%) compared to atropine group (5%). Thus, requirement of mephentermine for the management of hypotension was significantly high (p<0.001) in placebo (60%) than atropine group (5%).

Conclusion: Intravenous administration of atropine 0.6 mg, one min after induction of spinal anesthesia in elderly patient, is safe and effective method in the prevention of spinal anesthesia induced hypotension and bradycardia.

Author(s):

Shailendra Sigdel

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