Post-spinal anesthesia (PSA) hypotension in elderly patients is challenging.

Correction of PSA hypotension by fluids either colloids or crystalloids or by vasoconstrictors pose the risk of volume overload or compromising cardiac conditions.

Dexamethasone is used to treat conditions manifested by decrease of peripheral vascular resistance.

The research team was the first to test the hypothesis of its role in preventing or decreasing the incidence of PSA hypotension.

One hundred ten patients, aged 60 years or more were recruited to receive a single preoperative dose of dexamethasone 8 mg IVI in 100 ml normal saline (D group) (55 patients) 2 h preoperatively, and 55 patients were given placebo (C group) in a randomized, double-blind trial.

Variations in blood pressure and heart rate in addition to the needs of ephedrine and/or atropine following spinal anesthesia (SA) were recorded. SA was achieved using subarachnoid injection of 3 ml hyperbaric bupivacaine 0.5%.

Using a 9‐point Likert scale, panellists scored whether a treatment was: Not recommended, optional, or recommended.

Consensus was achieved when more than 70% of responses fell into the category defined by the mean.