Frailty, Spinal Anesthesia
Conditions
Brief summary
60 patients aged 65 and older with ASA I-III physical status undergoing elective surgery under spinal anesthesia will be included in the study. Patients with cardiac arrhythmia, severe heart failure, cerebrovascular disease, or contraindications to neuraxial anesthesia will be excluded. Frailty assessments will be performed using the Clinical Frailty Scale (CFS) version 2.0 by anesthesiologists in preoperative clinics or wards. Participants will be categorized into frail (CFS Level ≥4, Group I) and non-frail (CFS Level ≤3, Group II) groups. Prior to spinal anesthesia, 8 mL/kg of crystalloids will be administered. Baseline preoperative mean arterial blood pressure (MABP) and heart rate (HR) will be recorded as the average of three measurements in the supine position. During the study, MABP and HR will be monitored every 2 minutes for the first 20 minutes post-spinal anesthesia, then every 5 minutes until surgery ends. Hypotension (MABP \<80% of baseline) will be treated with 5 mg intravenous ephedrine, while bradycardia (HR \<50 beats/min) will be treated with 0.5 mg intravenous atropine.
Interventions
None listed
Sponsors
Selcuk University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 65 and older * ASA I-III physical status * Undergoing elective surgery under spinal anesthesia
Exclusion criteria
* Patients with cardiac arrhythmia * Patients with severe heart failure * Patients with cerebrovascular disease * Contraindications to neuraxial anesthesia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of Hypotension | Preoperative baseline, every 2 minutes for the first 20 minutes, and then at 5-minute intervals until the completion of the surgery. | Hypotension, defined as MABP below 80% of baseline values |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of Bradycardia | Preoperative baseline, every 2 minutes for the first 20 minutes, and then at 5-minute intervals until the completion of the surgery. | Bradycardia defined as HR \<50 beats/min |
| Ephedrine usage | During the procedure | Necessary use of ephedrine (mg) for patients who develop hypotension |
| Rate of Nausea and vomiting | up to 24 hours | Nausea and vomiting Visual analogue scale |
Outcome results
None listed