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 the induction of spinal anesthesia. Heart rate (HR), mean arterial pressure (MAP), requirement for mephentermine or phenylephrine, and the side effects profile were studied intra/postoperatively for 6 hours.
Results: The patients were comparable with respect to demographic profile, baseline hemodynamic parameters, and the duration of surgery. Compared to baseline, mean HR and MAP were significantly reduced in the placebo group most of the study times (p<0.05). The incidence of hypotension was high in placebo (60%) compared to the atropine group (5%). Thus, the requirement of mephentermine for the management of hypotension was significantly higher (p<0.001) in the placebo group (60%) than the atropine group (5%).
Conclusion: Intravenous administration of atropine 0.6 mg, one min after the induction of spinal anesthesia in an elderly patient, is a safe and effective method in the prevention of spinal anesthesia induced hypotension and bradycardia.
Keywords: Spinal anesthesia, hypotension, atropine, bradycardia