Midodrine for Improving Hemodynamics After Spinal Anesthesia
Status:
Completed
Trial end date:
2020-12-29
Target enrollment:
Participant gender:
Summary
Neuraxial blockade such as spinal anaesthesia can cause severe hypotension due to
pharmacological sympathectomy resulting in potential deleterious consequences for the
patient. Prevention of this spinal anaesthesia induced hypotension is of utmost importance.
Techniques currently in use for preventing hypotension include intravenous fluid
prehydration, sympathomimetic drugs, and physical methods such as leg bindings and
compression stockings. Midodrine is a direct acting α1-adrenoceptor agonist which causes
venous and arterial vasoconstriction through stimulation of α1- receptors located in the
vasculature. The aim of this study is to evaluate the efficacy and safety of prophylactic
midodrine use with preoperative fluid hydration before spinal anesthesia in the prevention of
hypotension in patients undergoing elective orthopedic surgery. We hypothesize that
intraoperative hypotension would be less in patients given midodrine and intravenous fluid
prehydration preoperatively before spinal anesthesia.