NCT03984526

Atropine or Ephedrine Pretreatment for Preventing Bradycardia in Elderly Patients

Comparison of Effect of Atropine or Ephedrine Pretreatment for Preventing Bradycardia Under Sedation With Dexmedetomidine After Spinal Anesthesia in Elderly Patients

• Status: Completed
• Phase: Phase 4
• Study type: Interventional
• Enrollment: 102 (actual)
• Sponsor: Ajou University School of Medicine · Academic / Other
• Sex: All
• Age: 65 Years – 100 Years
• Healthy volunteers: Not accepted

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.

Conditions

• Anesthesia, Spinal
• Dexmedetomidine
• Bradycardia

Interventions

Type	Name	Description
DRUG	normal saline	intravenous normal saline pretreatment at the onset of dexmedetomidine infusion
DRUG	atropine 0.5mg	intravenous atropine 0.5mg pretreatment at the onset of dexmedetomidine infusion
DRUG	ephedrine 8mg	intravenous ephedrine 8mg pretreatment at the onset of dexmedetomidine infusion

Timeline

• Start date: 2019-06-25
• Primary completion: 2020-09-15
• Completion: 2020-09-15
• First posted: 2019-06-13
• Last updated: 2021-02-04

Locations

1 site across 1 country: South Korea