Atropine or Ephedrine Pretreatment for Preventing Bradycardia in Elderly Patients
Status:
Completed
Trial end date:
2020-09-15
Target enrollment:
Participant gender:
Summary
Spinal anesthesia is widely used for lower extremity surgery, and sedation is often required
during surgery. For sedation, propofol, midazolam and dexmedetomidine are frequently used.
Dexmedetomidine is a highly selective alpha 2 receptor agonist, and has sedating and
analgesic effect. Compared with propofol and midazolam, it has little or no respiratory
inhibition and hemodynamically stable. It also has the effect of reducing delirium in the
elderly. Dexmedetomidine has also been reported to prolong the duration of sensory and motor
blockade effects of spinal anesthesia. However, several studies have reported that
administration of dexmedetomidine in spinal anesthesia increases the incidence of
bradycardia.
In a study of healthy young adults, concurrent administration of atropine with
dexmedetomidine in spinal anesthesia significantly reduced the frequency of bradycardia
requiring treatment. However, in elderly patients, it is often reported that there is little
response to atropine in bradycardia, and ephedrine is more effective in treating bradycardia
than atropine in the elderly.
The investigators therefore compared ephedrine and atropine as pretreatment to reduce the
incidence of bradycardia when using dexmedetomidine as a sedative in elderly patients
undergoing spinal anesthesia.