Body Mass Index, Urologic Surgical Procedures, Vasopressor Therapy
Conditions
Keywords
Body Mass Index, Ephedrine, Hemodynamic Response, Sensory Block
Brief summary
This single-center prospective observational study investigates the effect of body mass index (BMI) on intraoperative vasopressor requirements and spinal block characteristics in adult patients undergoing urological surgery under spinal anesthesia. Participants are classified into two cohorts according to BMI (\<27.5 kg/m² and ≥27.5 kg/m²).Patient enrollment for this prospective observational study started before trial registration; therefore, this record represents a retrospective registration.
Detailed description
This is a single-center prospective observational study conducted at a tertiary care hospital between May 2022 and December 2025. The study aims to evaluate the relationship between body mass index (BMI) and intraoperative ephedrine requirements, sensory and motor block characteristics, and hemodynamic responses in adult patients undergoing elective urologic surgery in the lithotomy position under spinal anesthesia. All patients received a standardized intrathecal dose of 3 mL 0.5% hyperbaric bupivacaine, and intraoperative hypotension was treated with intravenous ephedrine according to a predefined protocol. Patient enrollment for this prospective observational study began before registration of the study; therefore, this record represents a retrospective registration. Ethics approval was obtained from the institutional ethics committee prior to patient recruitment, and written informed consent was obtained from all participants.
Interventions
None listed
Sponsors
Adiyaman University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 years or older * American Society of Anesthesiologists (ASA) physical status I-II * Scheduled for elective urologic surgery under spinal anesthesia
Exclusion criteria
* Refusal to participate or lack of informed consent * Contraindications to spinal anesthesia * Height \<150 cm or \>190 cm * BMI \<18.5 kg/m²
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intraoperative ephedrine consumption (mg) | From spinal anesthesia induction until completion of surgery. | Cumulative intravenous ephedrine dose administered to treat hypotension (systolic arterial pressure \<90 mmHg or \>30% decrease from baseline) from the time of spinal anesthesia induction until the end of the surgical procedure. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maximum sensory block level | During intraoperative monitoring | Highest thoracic dermatome level reached after intrathecal injection of 3 mL 0.5% hyperbaric bupivacaine, assessed by pinprick testing every 2 minutes. |
| Time to reach maximum sensory block (minutes) | From intrathecal injection to maximum sensory level | Time in minutes from the intrathecal injection of hyperbaric bupivacaine until the maximum sensory block level is achieved. |
| Time to two-segment regression of sensory block | From maximum sensory block to two-dermatome regression | Time in minutes from the maximum sensory block level until regression of sensory block by two thoracic dermatomes. |
| Time to reach Bromage score 3 | From intrathecal injection to complete motor block | Time in minutes from the intrathecal injection until development of complete motor block in the lower extremities (Bromage score 3) |
| Motor block recovery time(minutes) | From intrathecal injection to earliest detectable return of motor activity | Time in minutes from the intrathecal injection until the earliest detectable return of motor function in the lower extremities. |
| Hemodynamic parameters | Baseline and every 5 minutes during surgery., | Noninvasive systolic and diastolic arterial pressure and heart rate measured at baseline (before spinal anesthesia) and then at 5-minute intervals throughout the surgical procedure. |
Countries
Turkey (Türkiye)
Outcome results
None listed