Age-related hemodynamic response to ephedrine in managing hypotension during neuraxial anesthesia: a prospective observational study.

Dinesh V.; Mithun B.; Akbar, A. Mohammed; Selvakumaran P.

Hypotension is a common complication during neuraxial anesthesia, particularly among elderly patients due to agerelated declines in β-adrenergic sensitivity. Ephedrine, a mixed α- and β-agonist, is frequently used to counteract hypotension, yet its efficacy may vary with age. This study evaluated the age-related hemodynamic response to ephedrine in middle-aged and elderly patients under neuraxial anesthesia. Study designed with 100 patients divided into middle-aged (45--64 years) and elderly (≥65 years) groups, the research monitored key hemodynamic parameters such as systolic and diastolic blood pressure, mean arterial pressure (MAP), and heart rate during and after surgery. Elderly patients exhibited a reduced response to ephedrine, with lower increases in MAP (mean 81 ± 6 mmHg) compared to middle-aged patients (87 ± 6 mmHg). The elderly group also required additional vasopressors more frequently to achieve target blood pressures. Age significantly affects the efficacy of ephedrine in managing hypotension during neuraxial anesthesia. These findings highlight the significant impact of age on the effectiveness of ephedrine for managing hypotension in neuraxial anesthesia. Consequently, the study suggests the necessity for age-adjusted dosing and the exploration of alternative vasopressors for elderly patients to optimize hemodynamic outcomes.

DIASTOLIC blood pressure; OLDER patients; SYSTOLIC blood pressure; BLOOD pressure; HEART beat

Pravara Medical Review, 2024, Vol 16, Issue 4, p41

0975-0533

Academic Journal

10.36848/PMR/2024/00000.10230