Efficacy of Dexamethasone in Attenuation of Postinduction Hypotension in Geriatric Patients Undergoing General Anesthesia
Status:
Completed
Trial end date:
2021-09-15
Target enrollment:
Participant gender:
Summary
- Geriatric patients who undergo general anesthesia experience post induction hypotension
which is treated with intravenous fluids and ephedrine. The main cause of post-induction
hypotension is the decrease in the sympathetic outflow causing arterial vasodilatation,
a decrease in venous return and consequently the activation of the Bezold Jarish reflex
(BJR) that elicits a triad of bradycardia, vasodilatation and further hypotension. BJR
is elicited by activation of 5-HT3 receptors within the intracardiac vagal nerve
endings.
- Glucocorticoids in general inhibit 5-HT3 expression and dexamethasone was found to
decrease the level of 5-HT3 in the cerebral cortex and hippocampus in developing rats.
So, the research team hypothesizes that dexamethasone can attenuate the postinduction
hypotension in geriatric patients undergoing general anesthesia if administered
preoperatively.