To evaluate the efficacy of prophylactic intravenous dexamethasone in attenuating postspinal hypotension in geriatric patients undergoing lower limb orthopaedic surgery- A randomised controlled double blind study

Post-spinal hypotension is a common complication following spinal anaesthesia, particularly in elderly patients, due to decreased sympathetic tone and impaired compensatory cardiovascular responses. This may lead to adverse outcomes if not promptly managed. Various preventive strategies including fluid loading and vasopressors have been used; however, these may be associated with undesirable side effects. Dexamethasone, a commonly used corticosteroid, may attenuate spinal-induced hypotension by reducing activation of the Bezold–Jarisch reflex and enhancing vascular responsiveness to vasoconstrictors.

This prospective, randomized, double-blind, placebo-controlled study aims to evaluate the efficacy of prophylactic intravenous dexamethasone in reducing the incidence of post-spinal hypotension in geriatric patients undergoing lower limb orthopaedic surgery under spinal anaesthesia. Seventy patients aged 65 years or older will be randomly allocated to receive either intravenous dexamethasone or placebo prior to spinal anaesthesia. Hemodynamic parameters, vasopressor requirement, intravenous fluid administration, and adverse events will be recorded and compared between the two groups.