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

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

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.

Study Overview

• Status: Recruiting
• Conditions: Urologic Neoplasms; Hypotension; Spinal Anesthesia; Aged
• Intervention / Treatment: Other: Skin Conductance Monitoring

Detailed Description

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 (Estimated): 102

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Yenimahalle
    • Ankara, Yenimahalle, Turkey (Türkiye), 06200
      • Recruiting
      • Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital Clinic of Anesthesiology and Rea
      • Contact: Belkis YILMAZ, Dr; Phone Number: +905363275575; Email: drbelkisyilmaz@gmail.com

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of geriatric patients aged 65 years and older who are scheduled to undergo elective urologic oncology surgery under spinal anesthesia at a tertiary oncology training and research hospital. Eligible patients meeting the inclusion criteria will be prospectively enrolled. Perioperative skin conductance and hemodynamic parameters will be monitored to evaluate the association between sympathetic nervous system activity and the development of spinal anesthesia-induced hypotension.

Description

Inclusion Criteria:

• 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

Exclusion Criteria:

• 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)

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Geriatric Urologic Oncology Patients Undergoing Spinal Anesthesia; Geriatric patients undergoing urologic oncology surgery under spinal anesthesia will be prospectively observed. Skin conductance will be continuously monitored perioperatively as a noninvasive indicator of sympathetic nervous system activity. Hemodynamic parameters, including blood pressure and heart rate, will be recorded before and after spinal anesthesia. The occurrence of spinal anesthesia-induced hypotension will be assessed and its association with skin conductance measurements will be evaluated.

Other: 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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number 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.	From initiation of spinal anesthesia until 20 minutes after spinal anesthesia.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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.	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.	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.	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.	From baseline measurement before spinal anesthesia until 20 minutes after spinal anesthesia

Collaborators and Investigators

• Sponsor: Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

Publications and helpful links

General Publications

• 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.
• 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.
• 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.

Study record dates

Study Major Dates

• Study Start (Actual): December 22, 2025
• Primary Completion (Estimated): April 1, 2026
• Study Completion (Estimated): May 1, 2026

Study Registration Dates

• First Submitted: March 16, 2026
• First Submitted That Met QC Criteria: March 16, 2026
• First Posted (Actual): March 19, 2026

Study Record Updates

• Last Update Posted (Actual): March 25, 2026
• Last Update Submitted That Met QC Criteria: March 23, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Urogenital Diseases; Vascular Diseases; Cardiovascular Diseases; Urogenital Neoplasms; Neoplasms by Site; Neoplasms; Male Urogenital Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Hypotension; Urologic Neoplasms
• Other Study ID Numbers: 2025-12/205

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data collected during this study will not be made publicly available. The dataset contains sensitive clinical information, and data sharing is restricted to protect participant confidentiality in accordance with institutional policies and ethical regulations. However, de-identified data may be made available from the corresponding investigator upon reasonable request and with appropriate ethical approval.

Drug and device information, study documents

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