Predictors of Spinal Anesthesia-Induced Hypotension in Hypertensive Patients

Determining Factors That Predict Hypotension Related to Spinal Anesthesia in Patients With Hypertension

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.

Study Overview

• Status: Completed
• Conditions: Spinal Anesthesia-Induced Hypotension

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.

• Study Type: Observational
• Enrollment (Actual): 110

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Karatay
    • Konya, Karatay, Turkey (Türkiye), 42020
      • Konya City Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study will include adult hypertensive patients scheduled for elective surgical procedures under spinal anesthesia at Konya City Hospital. The target population comprises patients with hypertensive patients (ASA II-III classification), who are deemed fit for elective surgery and spinal anesthesia by their clinical teams.

Eligible participants will be screened based on inclusion and exclusion criteria. The study population represents a subset of hypertensive individuals with varying durations of hypertension, medication regimens, and cardiovascular profiles. Patients will be recruited from preoperative assessment clinics and surgical wards at the hospital.

Description

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.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of Spinal Anesthesia-Induced Hypotension (SASH)	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.	30 minutes after spinal anesthesia.

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Predictive Value of Internal Jugular Vein Collapsibility Index	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.	Pre-anesthesia measurement.
Flow-Mediated Dilation (FMD)	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.	Pre-anesthesia measurement.
Carotid Corrected Flow Time (CFTc)	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.	Pre-anesthesia measurement.

Collaborators and Investigators

• Sponsor: Konya City Hospital

Study record dates

Study Major Dates

• Study Start (Actual): January 3, 2025
• Primary Completion (Actual): June 10, 2025
• Study Completion (Actual): June 10, 2025

Study Registration Dates

• First Submitted: December 19, 2024
• First Submitted That Met QC Criteria: December 23, 2024
• First Posted (Actual): December 27, 2024

Study Record Updates

• Last Update Posted (Actual): November 17, 2025
• Last Update Submitted That Met QC Criteria: November 14, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: Hypotension; Spinal Anesthesia; Hypertensive Patients; Hemodynamic Predictors
• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Hypotension
• Other Study ID Numbers: 3.05.2024-27769

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No