Efficacy of Dexamethasone in preventing post spinal hypotension in elderly patients undergoing orthopedic surgery; A Randomized Control Trial at a tertiary care hospital

Objective: To compare the efficacy of single pre-operative dose of intravenous Dexamethasone vs placebo in elderly patients undergoing orthopedic surgeries in spinal anesthesia in terms of number of hypotensive episodes. Methodology: After ethical approval and clinical trial registration (NCT07052864), study was carried out at Department of Anesthesiology and Critical Care Medicine, PIMS Hospital, Islamabad from 30th June 2025 to 30th August 2025. A total of 134 patients were enrolled who were 50 years to 100 years belonging to ASA I & II. Group A patients were given single preoperative dose of dexamethasone 8?mg IV in 100?ml normal saline 1 hour before induction of spinal anesthesia in the pre-operative area while group B patients were given placebo. Results: The incidence of intra operative hypotension was significantly higher in group B than group A. The incidence in group B was 70% and in group A it was 45% with p value being 0.003. Similarly intraoperative phenylephrine consumption was 0.00 (50.00) in group A while in group B it was 50.00 (200.00) with p value being 0.02. Conclusion: Prophylactic administration of Intravenous Dexamethasone is effective in preventing post spinal hypotension and reducing intraoperative vasopressor requirements among elderly patients undergoing lower limb orthopedic surgeries.