Skin Conductance for Predicting Spinal Anesthesia-Induced Hypotension in Geriatric Urologic Oncology Patients

Официальное название

Skin Conductance as a Predictor of Spinal Anesthesia-Induced Hypotension in Geriatric Oncology Patients

Обзор

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.

Подробное описание

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.

Вмешательства

• Другое Skin Conductance Monitoring
  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.

Первичные конечные точки

• Number of Participants with Spinal Anesthesia-Induced Hypotension [Срок оценки: From initiation of spinal anesthesia until 20 minutes after spinal anesthesia.]

Вторичные конечные точки (4)

• Incidence of Bradycardia After Spinal Anesthesia [Срок оценки: From initiation of spinal anesthesia until 20 minutes after spinal anesthesia]
• Maximum Percentage Decrease in Mean Arterial Pressure (MAP) [Срок оценки: From initiation of spinal anesthesia until 20 minutes after spinal anesthesia.]
• Number of Participants Requiring Vasopressor Administration [Срок оценки: From initiation of spinal anesthesia until 20 minutes after spinal anesthesia.]
• Changes in Skin Conductance Values [Срок оценки: From baseline measurement before spinal anesthesia until 20 minutes after spinal anesthesia]

Критерии участия

Критерии включения

• Patients aged 65 years and older
• Patients scheduled for elective urologic oncology surgery under spinal anesthesia
• American Society of Anesthesiologists (ASA) physical status I-III
• Patients who provide written informed consent to participate in the study

Критерии исключения

• Refusal to participate or inability to provide informed consent
• Contraindication to spinal anesthesia (e.g., infection at puncture site, coagulopathy)
• Severe cardiac conduction abnormalities or presence of a cardiac pacemaker
• Severe autonomic dysfunction or known neuropathy affecting autonomic responses
• Use of medications that significantly affect autonomic nervous system activity
• Baseline hypotension or hemodynamic instability before spinal anesthesia
• Inability to obtain reliable skin conductance measurements (e.g., severe skin lesions at electrode placement site)

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Turkey (Türkiye) · 1 центр

• Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital Clinic of Anesth — Ankara

Публикации

• Norbeck DW, Lindgren S, Wolf A, Jildenstal P. Reliability of nociceptive monitors vs. standard practice during general anesthesia: a prospective observational study. BMC Anesthesiol. 2025 Jan 31;25(1):51. doi: 10.1186/s12871-025-02923-4. PMID 39891061
• Storm H. Changes in skin conductance as a tool to monitor nociceptive stimulation and pain. Curr Opin Anaesthesiol. 2008 Dec;21(6):796-804. doi: 10.1097/ACO.0b013e3283183fe4. PMID 18997532
• Ledowski T, Preuss J, Kapila R, Ford A. Skin conductance as a means to predict hypotension following spinal anaesthesia. Acta Anaesthesiol Scand. 2008 Nov;52(10):1342-7. doi: 10.1111/j.1399-6576.2008.01697.x. PMID 19025525

Идентификаторы

NCT: NCT07481851 · 2025-12/205

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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