Spinal anesthesia-induced hypotension is a common and clinically significant complication in elderly patients undergoing oncologic surgery. Early identification of patients at risk for hemodynamic instability remains a major challenge in perioperative management. Skin conductance reflects sympathetic nervous system activity and may provide a noninvasive indicator of autonomic responses. This prospective observational study aims to evaluate whether skin conductance measurements can predict the development of hypotension following spinal anesthesia in geriatric oncology patients undergoing urologic surgery. The findings may contribute to improved perioperative monitoring and early risk stratification in this vulnerable patient population.
Spinal anesthesia is widely used in urologic oncology surgery due to its favorable analgesic profile and reduced systemic anesthetic exposure. However, spinal anesthesia frequently leads to significant hemodynamic changes, particularly hypotension, which is more pronounced in elderly patients because of age-related alterations in autonomic regulation, reduced cardiovascular reserve, and increased comorbidity burden. Spinal anesthesia-induced hypotension may result in inadequate tissue perfusion and increased perioperative morbidity, making early identification of patients at risk an important aspect of perioperative management. Skin conductance is a noninvasive physiological parameter reflecting sympathetic nervous system activity and sudomotor responses. Changes in skin conductance have been associated with variations in autonomic nervous system activity and may provide an indirect indicator of hemodynamic responses. Continuous monitoring of skin conductance may therefore offer a potential method for identifying patients who are more likely to develop hypotension after spinal anesthesia. The aim of this prospective observational study is to investigate the relationship between skin conductance measurements and the development of hypotension following spinal anesthesia in geriatric oncology patients undergoing urologic surgery. Hemodynamic parameters including blood pressure and heart rate will be monitored perioperatively, and their association with skin conductance measurements will be evaluated. The results of this study may contribute to improving perioperative monitoring strategies and risk prediction in elderly oncology patients undergoing spinal anesthesia.
Study Type
OBSERVATIONAL
Enrollment
102
Skin conductance will be continuously monitored using a noninvasive electrodermal activity monitoring device to assess sympathetic nervous system activity during the perioperative period. Measurements will be recorded before and after spinal anesthesia and evaluated in relation to the development of spinal anesthesia-induced hypotension.
Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital Clinic of Anesthesiology and Rea
Ankara, Yenimahalle, Turkey (Türkiye)
RECRUITINGNumber of Participants with Spinal Anesthesia-Induced Hypotension
The number of participants who experience hypotension, defined as a decrease in mean arterial pressure (MAP) of ≥20% from baseline or a MAP \<65 mmHg, within 20 minutes after spinal anesthesia. Time Frame: From initiation of spinal anesthesia until 30 minutes after spinal anesthesia.
Time frame: From initiation of spinal anesthesia until 20 minutes after spinal anesthesia.
Incidence of Bradycardia After Spinal Anesthesia
The number of participants who experience bradycardia, defined as a heart rate of less than 50 beats/min, within 20 minutes after spinal anesthesia.
Time frame: From initiation of spinal anesthesia until 20 minutes after spinal anesthesia
Maximum Percentage Decrease in Mean Arterial Pressure (MAP)
The maximum percentage drop in MAP from the baseline value recorded for each participant during the observation period.
Time frame: From initiation of spinal anesthesia until 20 minutes after spinal anesthesia.
Number of Participants Requiring Vasopressor Administration
The number of participants who require at least one dose of vasopressor (e.g., ephedrine or phenylephrine) to treat hypotension according to the study protocol.
Time frame: From initiation of spinal anesthesia until 20 minutes after spinal anesthesia.
Changes in Skin Conductance Values
The average change in the number of skin conductance fluctuations (peaks per second) from baseline to the point of maximum hemodynamic change.
Time frame: From baseline measurement before spinal anesthesia until 20 minutes after spinal anesthesia
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