Predictors of Unilateral Spinal Block Success (UNISS)
Determination of Factors Affecting Success in Unilateral Spinal Anesthesia: A Prospective Observational Study
This prospective observational study aims to determine the factors affecting the success of unilateral spinal anesthesia in patients undergoing orthopedic lower extremity surgery. Unilateral spinal anesthesia is preferred to minimize unwanted effects such as hypotension and to provide more stable hemodynamic conditions, especially in vulnerable patient populations.
Unilateral spinal anesthesia is defined as achieving sensory and motor block predominantly on the operated side without significant contralateral spread. However, the factors influencing the success of this technique have not been fully clarified.
This study will evaluate various patient-related and procedure-related factors, including age, sex, body mass index, patient positioning, needle type and orientation, injection technique and local anesthetic dose. The primary outcome is the success of unilateral spinal anesthesia, defined as the absence of contralateral block.
The results of this study are expected to contribute to improving clinical practice by identifying major and minor factors affecting block success and optimizing anesthesia techniques.
Tutkimuksen yleiskatsaus
Tila
Yksityiskohtainen kuvaus
This prospective observational study is designed to investigate the factors influencing the success of unilateral spinal anesthesia in patients undergoing lower extremity orthopedic surgery.
Spinal anesthesia is widely used in lower extremity procedures; however, it may be associated with hemodynamic instability such as hypotension. Unilateral spinal anesthesia has been proposed as a technique to limit sympathetic blockade and maintain more stable hemodynamic conditions. Despite its advantages, the determinants of successful unilateral block remain unclear.
Patients aged between 18 and 65 years with American Society of Anesthesiologists (ASA) physical status I-III who are scheduled for elective lower extremity surgery will be included in the study after providing written informed consent. This study will be conducted in a single tertiary care center.
No intervention will be performed by the investigator. All anesthesia procedures will be carried out according to routine clinical practice. The investigator will record patient demographics, including age, sex, height, weight, and body mass index.
Procedure-related variables such as patient positioning, spinal needle type, needle orientation, injection speed, level of injection, local anesthetic type and dose will be recorded.
Block characteristics will be assessed intraoperatively, including sensory and motor block distribution. The primary outcome is defined as successful unilateral spinal anesthesia, characterized by the absence of contralateral sensory block. Secondary outcomes include factors associated with block success and variability in block characteristics.
Data will be collected using standardized case report forms and analyzed to identify factors influencing the success of unilateral spinal anesthesia. The results of this study are expected to contribute to optimizing anesthesia techniques and improving patient safety.
Opintotyyppi
Ilmoittautuminen (Todellinen)
Yhteystiedot ja paikat
Opiskelupaikat
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Izmir, Turkki (Türkiye)
- İzmir City Hospital
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Näytteenottomenetelmä
Tutkimusväestö
Kuvaus
Inclusion Criteria:
- Patients aged 18-65 years
- ASA physical status I-III
- Undergoing elective unilateral lower extremity surgery under spinal anesthesia
- Provided written informed consent
Exclusion Criteria:
- ASA IV patients
- Known allergy to local anesthetics
- Contraindications to spinal anesthesia
- Decompensated congestive heart failure
- Hemodynamic instability (including sepsis, septic shock, or need for inotropic support)
- Pregnancy
- Patients with vertebral anomalies (e.g., scoliosis, vertebral fractures) preventing proper positioning
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
Kohortit ja interventiot
Ryhmä/Kohortti |
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patients undergoing unilateral spinal anesthesia
Patients aged 18-65 years with ASA physical status I-III undergoing elective unilateral lower extremity surgery under spinal anesthesia.
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Unilateral Spinal Block Success Rate
Aikaikkuna: Intraoperative period (within first 30 minutes after spinal anesthesia
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Successful unilateral spinal anesthesia defined as the absence of contralateral sensory block, assessed by pinprick test and bromage scale within the first 20 minutes after spinal anesthesia.
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Intraoperative period (within first 30 minutes after spinal anesthesia
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Rate of unilateral spinal anesthesia success by age
Aikaikkuna: Intraoperative period
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Proportion (%) of patients achieving unilateral spinal anesthesia success across age groups.
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Intraoperative period
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Rate of unilateral spinal anesthesia success by BMI
Aikaikkuna: Intraoperative period
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Proportion (%) of patients achieving unilateral spinal anesthesia success across age groups.
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Intraoperative period
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Rate of unilateral spinal anesthesia success by position
Aikaikkuna: Intraoperative period
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Proportion (%) of unilateral spinal anesthesia success by patient positioning during injection (lateral vs sitting).
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Intraoperative period
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Rate of unilateral spinal anesthesia success by needle type
Aikaikkuna: Intraoperative period
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Proportion (%) of unilateral spinal anesthesia success by spinal needle type (Quincke vs pencil-point).
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Intraoperative period
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Rate of unilateral spinal anesthesia success by needle gauge
Aikaikkuna: Intraoperative period
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Proportion (%) of unilateral spinal anesthesia success by needle gauge.
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Intraoperative period
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Rate of unilateral spinal anesthesia success by local aneshtetic dose
Aikaikkuna: Intraoperative period
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Proportion (%) of unilateral spinal anesthesia success by administered local anesthetic dose (mg).
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Intraoperative period
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Rate of unilateral spinal anesthesia success by injection speed
Aikaikkuna: Intraoperative period
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Proportion (%) of unilateral spinal anesthesia success by injection speed category (faster vs ≤1 mL/5 s).
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Intraoperative period
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Sensory Block Level and Distribution
Aikaikkuna: Intraoperative period
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Assessment of sensory block level (dermatomal level) and comparison between operated and non-operated sides.
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Intraoperative period
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Rate of unilateral spinal anesthesia success by intervertebral level of spinal injection
Aikaikkuna: Intraoperative period
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Proportion (%) of unilateral spinal anesthesia success by intervertebral level (L1-2,L2-3,L3-L4 ,L4-L5).
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Intraoperative period
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Yhteistyökumppanit ja tutkijat
Sponsori
Tutkijat
- Päätutkija: Derya Arslan Yurtlu, MD, İzmir City Hospital
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Ensisijainen valmistuminen (Todellinen)
Opintojen valmistuminen (Todellinen)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Avainsanat
Muut tutkimustunnusnumerot
- UNISS-2025
Yksittäisten osallistujien tietojen suunnitelma (IPD)
Aiotko jakaa yksittäisten osallistujien tietoja (IPD)?
IPD-suunnitelman kuvaus
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