Spinal Anesthesia-Induced Hypotension
Conditions
Keywords
Spinal Anesthesia, Hypotension, Hypertensive Patients, Hemodynamic Predictors
Brief summary
This prospective observational study aims to evaluate predictive factors for spinal anesthesia-induced hypotension (SASH) in hypertensive patients undergoing elective surgery. Parameters such as internal jugular vein collapsibility index, carotid intima-media thickness, and flow-mediated dilation will be assessed using ultrasonography to determine their association with SASH. Demographic, anthropometric, and hemodynamic data will also be analyzed. The findings may improve perioperative management strategies for hypertensive patients receiving spinal anesthesia.
Detailed description
This study aims to investigate the relationship between carotid intima-media thickness (CIMT) and spinal anesthesia-induced hypotension (SASH) in hypertensive patients. SASH is a common side effect of spinal anesthesia, with an incidence ranging from 15% to 33%, and is associated with significant clinical consequences such as increased morbidity and mortality. CIMT is a well-established marker of atherosclerotic burden and cardiovascular risk. This study hypothesizes that CIMT may be an independent predictor of SASH in hypertensive patients. Participants will undergo preoperative CIMT measurements and standardized spinal anesthesia procedures, with hemodynamic variables and potential risk factors recorded for analysis.
Interventions
None listed
Sponsors
Konya City Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Adult hypertensive patients classified as ASA II-III risk group. Patients scheduled for elective surgeries requiring spinal anesthesia.
Exclusion criteria
Presence of severe renal or hepatic failure, or severe respiratory or cardiovascular diseases. Contraindication to spinal anesthesia. Failure of spinal anesthesia. History of carotid surgery or presence of carotid plaques. Presence of anxiety.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Spinal Anesthesia-Induced Hypotension (SASH) | 30 minutes after spinal anesthesia. | Percentage of patients experiencing a decrease in systolic blood pressure by 20% or more from baseline or a drop below 90 mmHg during the first 30 minutes following spinal anesthesia. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Predictive Value of Internal Jugular Vein Collapsibility Index | Pre-anesthesia measurement. | The collapsibility index of the inferior vena cava (IVC) will be measured using ultrasound. Measurements will be obtained during inspiration and expiration, and the collapsibility index will be calculated as \[(IVC diameter during expiration - IVC diameter during inspiration) / IVC diameter during expiration\] × 100%. Measurements will be performed preoperatively and 30 minutes after spinal anesthesia induction. |
| Flow-Mediated Dilation (FMD) | Pre-anesthesia measurement. | FMD will be measured using high-resolution ultrasound to assess endothelial function. Measurements will be performed on the brachial artery at baseline and after inducing hyperemia with a blood pressure cuff. FMD will be calculated as \[(post-hyperemia diameter - baseline diameter) / baseline diameter\] × 100%. The average of three repeated measurements will be recorded for analysis. |
| Carotid Corrected Flow Time (CFTc) | Pre-anesthesia measurement. | Carotid Corrected Flow Time (CFTc) will be measured using Doppler ultrasound at the common carotid artery. The uncorrected carotid flow time will be adjusted for heart rate using Bazett's formula (CFTc = observed flow time / √(R-R interval)). Measurements will be taken preoperatively and at 30 minutes after spinal anesthesia induction. The average of three consecutive measurements will be recorded. |
Countries
Turkey (Türkiye)
Outcome results
None listed