الفهرس 
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Abstract
Spinal anesthesia is preferred by anesthetists in elderly patients however, its common and sometimes dangerous complications may limit its use. Hypotension and bradycardia are the most frequent complications. This study was carried out at Beni-Suef University Hospital on patients aged 60 years or older undergoing lower limb orthopedic surgeries to evaluate the role of intrathecal dexamethasone in decreasing the incidence of post spinal anesthesia hypotension in geriatric patients undergoing orthopedic surgery.
This study revealed that the mean arterial blood pressure showed no significant difference between the studied groups regarding their baseline. However, at all measure the MAP was higher in dexamethasone group than the control group.
Follow up of systolic blood pressure demonstrated a significant decrease of systolic blood pressure in dexamethasone group from before till the fourth measure with steady measure from 3rd to 4th measure but in control group there was steadiness of SBP from the second till the fourth measure. However, there was a significant high systolic BP in dexamethasone group than control group in the 1st (125.7±16.3 Vs 116.1±18.3), 2nd (123.9±12.4 Vs 110.9±18.1), 3rd (119.9±14.1 Vs 107.1±17.9) and the 4th (118.4±13.4 Vs 106.2±15.9) measurements.
Follow up of diastolic blood pressure demonstrated that there was a significant decrease of diastolic blood pressure both groups at different times. However, there was high diastolic BP in dexamethasone group than the control group from 2nd (64.7±8.2 Vs 60.3±9.3) to 3rd measure (64.4±8.7 Vs 59±10.3).
There was a significant increased heart rate in control group than dexamethasone group at the 2nd (93.7±16.5 Vs 84.8±14), 3rd (93.7±16.5 Vs 84.1±14.3) and 4th (93.2±15.6 Vs 83.5±13.1) measurements.
The mean age of patients in dexamethasone group was 67.8±6.8 years and most of them were females (72.5%). The majority of patients in dexamethasone and control group were ASA I (62.5% Vs 57.5%) respectively with no significant differences between both groups. Also, the body weight did not differ significantly between both groups with average 76.6±10.3 Kg in dexamethasone group and 76.9±10.6 Kg in control group.
There was a significant increase of Bromage score in dexamethasone group after 5 minutes postoperative only (4±0.0 Vs 3.8±0.5). There was insignificant difference of Bromage score in both groups after 10 and 15 minutes postoperative and in each group at different times.
There was a significant higher proportion of patients not in need to ephedrine and atropine in dexamethasone than control group (97.5% Vs (37.5%). The mean dose of ephedrine required by dexamethasone group was 15±0.0 and for control group was 26.3±11.1.
There was insignificant higher proportion of patients without complications in the form of nausea, vomiting and shivering in dexamethasone group than control group (100% Vs 87.5%)) but with clinical significance.