Title
Prospective randomized study to assess the effect of intramuscular glycopyrrolate on hypotension prevention among elderly patients following subarachnoid block during lower limb surgeries
Authors
Neetesh Gautam¹,*, Narayan Hari Sharma¹, Irfan Khan² & Shubham Mittal¹
Affiliation
¹Department of Anaesthesiology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India; ²Department of Anaesthesiology, Janak Hospital, Gwalior, Madhya Pradesh, India; *Corresponding author
Neetesh Gautam - E-mail: neeteshgautamgrmc@gmail.com
Narayan Hari Sharma - E-mail: narayanhari.sharma@gmail.com
Irfan Khan - E-mail: khanirfan.260@gmail.com
Shubham Mittal - E-mail: drmittalshubham@gmail.com
Article Type
Research Article
Date
Received May 1, 2026; Revised May 31,
2026; Accepted May 31, 2026, Published May 31, 2026
Abstract
Spinal anesthesia is a preferred technique for lower limb surgeries in elderly patients but often leads to hypotension due to sympathetic blockade and diminished cardiovascular adaptability. Glycopyrrolate, an anticholinergic agent, may mitigate this response by sustaining heart rate and venous return. Hence, this prospective randomized study evaluated 50 elderly patients (≥ 60 years) undergoing elective lower limb surgery under spinal anesthesia, divided into a glycopyrrolate group (0.2 mg IM given 30 minutes pre-block) and a control group without premedication. Hemodynamic parameters were recorded intraoperatively and compared between groups. The glycopyrrolate group showed significantly fewer cases of hypotension, better maintenance of mean arterial pressure and heart rate and a reduced need for vasopressors, without notable adverse effects such as tachycardia or dry mouth. Thus, we show that the pre-anesthetic intramuscular glycopyrrolate is a simple, safe and effective measure to enhance hemodynamic stability and prevent hypotension in elderly patients receiving spinal anesthesia.
Keywords
Glycopyrrolate, spinal anesthesia, hypotension, elderly, subarachnoid block, lower limb surgery
Citation
Gautam et al. Bioinformation 22(5): 3067-3071 (2026)
Edited by
P Kangueane
ISSN
0973-2063
Publisher
License
This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.
