AI Article Synopsis

  • Societies are aging, leading to increased attention on the challenges of anesthesia in elderly patients, particularly spinal anesthesia.
  • Hypotension is a common complication of spinal anesthesia, posing risks for serious perioperative issues like heart attacks and kidney failure if not treated effectively.
  • This study focuses on the use of vasoconstrictors, especially ephedrine and phenylephrine, for managing hypotension in elderly patients, highlighting that existing research primarily involves obstetric patients rather than the elderly, resulting in inconclusive findings.

Article Abstract

Demographic data clearly show the progressive aging of societies. Problems and specificity of anaesthesia in the elderly becomes a particularly important issue in this context. Spinal anesthesia is a method often used to anesthetize elderly patients, and hypotension is one of its most common early complications. Untreated or improperly treated hypotension increases the risk of perioperative complications such as myocardial infarction, ischemic stroke or acute renal failure. The prevention of hypotension consists of intravenous fluid therapy and pre-emptive use of vasoconstrictor drugs. Among vasoconstrictors, ephedrine and phenylephrine are commonly used to treat hypotension due to spinal anaesthesia. Both drugs are available in Poland. Issues related to their use in the treatment of hypotension caused by spinal anaesthesia in the elderly, including the features of both drugs, their method of administration and dosage based on the literature and own experience are the subject of this study. It should be noted, however, that most studies in the use of ephedrine and phenylephrine as a targeted treatment for hypotension concern the obstetric patient population while the elderly population is underrepresented and the results are inconclusive.

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