58 elderly patients undergoing hip arthroplasty under spinal anesthesia were randomized to receive either 5 mg oral midodrine (n=29) or a placebo (n=29). The primary outcome of interest was intraoperative ephedrine consumption. Secondary outcomes included the incidence of post-spinal hypotension, bradycardia, hypertension, mean arterial pressure (MAP), and heart rate (HR). Outcomes were assessed throughout the duration of the surgery. Overall, the results of the study revealed that the midodrine group had significantly lower intraoperative ephedrine consumption and a reduced incidence of hypotension compared to the control group. The findings suggest that oral midodrine is effective in decreasing vasopressor requirements and the incidence of hypotension in elderly patients undergoing hip arthroplasty.