Internal Jugular Vein Ultrasound for Predicting Hypotension in Geriatric Patients Undergoing Spinal Anesthesia

NCT07411313 | Recruiting

• 1 other identifier: 2023-12/509
• Study Type: observational
• Target: 85
• Locations: 1 country
• Sites: 1

Brief Summary

Spinal anesthesia-induced hypotension is a common and clinically significant complication in geriatric patients. Accurate preoperative assessment of intravascular volume status may help identify patients at risk. Internal jugular vein (IJV) ultrasonography is a noninvasive and easily applicable bedside method that reflects venous volume status. This prospective observational study aims to evaluate the role of preoperative IJV ultrasonographic measurements in predicting hypotension following spinal anesthesia in geriatric patients. Patients aged 65 years and older undergoing elective surgery under spinal anesthesia will be included. Preoperative IJV diameter, cross-sectional area, and collapsibility index will be measured using ultrasonography. Hemodynamic parameters will be monitored intraoperatively, and the occurrence of hypotension after spinal anesthesia will be recorded. The predictive value of IJV ultrasonographic parameters for post-spinal hypotension will be analyzed

Conditions

Spinal Anesthesia Induced Hypotension; Geriatric; Internal Jugular Vein; Ultrasonography

Keywords

Geriatric patients; Spinal anesthesia; Hypotension; Ultrasonography; Internal jugular vein

Outcome Measures

Primary Outcomes (1)

• Post-spinal hypotension

  Post-spinal hypotension was defined as a decrease of more than 20% in systolic blood pressure or mean arterial pressure from baseline, or an absolute mean arterial pressure \<65 mmHg following spinal anesthesia. During the operation, systolic, diastolic, and mean arterial blood pressures and heart rate were recorded immediately after spinal anesthesia (0 minute), at 3-minute intervals during the first 15 minutes, at 15-minute intervals between 15 and 60 minutes, and at 90 minutes intraoperatively. For surgeries lasting less than 90 minutes, measurements were recorded until the end of surgery.

  From spinal anesthesia administration up to 90 minutes intraoperatively.

Study Arms (2)

Hypotension Group

Geriatric patients who developed hypotension after spinal anesthesia.

Other: Not applicable- observational study

Non-Hypotension Group

Geriatric patients who did not develop hypotension after spinal anesthesia

Other: Not applicable- observational study

Interventions

Not applicable- observational study OTHER

Not applicable- observational study

Hypotension Group; Non-Hypotension Group

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

This study will include geriatric patients aged 65 years and older, classified as ASA I-III, scheduled for surgery under spinal anesthesia, and able to provide written informed consent. Patients with severe cardiac dysfunction, extreme obesity, or hemodynamic instability will be excluded.

You may qualify if:

• Age ≥65 years
• Scheduled to undergo surgery under spinal anesthesia
• American Society of Anesthesiologists (ASA) physical status I-III
• Able and willing to provide written informed consent

You may not qualify if:

• Did not provide written informed consent
• Undergoing emergency surgery
• Body mass index (BMI) ≥40 kg/m²
• Receiving angiotensin-converting enzyme (ACE) inhibitors
• Pre-spinal systolic blood pressure \<90 mmHg or mean arterial pressure \<70 mmHg
• Unable to tolerate the supine position
• Left ventricular ejection fraction \<40%
• Requiring sedoanalgesia in addition to spinal anesthesia or conversion to general anesthesia

Sponsors & Collaborators

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

Study Sites (1)

Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital

Ankara, YENİMAHALLE, 06200, Turkey (Türkiye)

RECRUITING

Related Publications (8)

• Kaur K, Sara H, Duggal G, Depuru A, Reddy A, Bansal N. The Use of the Internal Jugular Vein Collapsibility Index (IJVCI) for the Prediction of Postspinal Hypotension in Geriatric Patients Posted for Lower Limb Surgeries. Cureus. 2025 Jan 2;17(1):e76824. doi: 10.7759/cureus.76824. eCollection 2025 Jan.

  PMID: 39897318 RESULT

• Klohr S, Roth R, Hofmann T, Rossaint R, Heesen M. Definitions of hypotension after spinal anaesthesia for caesarean section: literature search and application to parturients. Acta Anaesthesiol Scand. 2010 Sep;54(8):909-21. doi: 10.1111/j.1399-6576.2010.02239.x. Epub 2010 Apr 23.

  PMID: 20455872 RESULT

• N P, Sinha M, Kumar M, Ramchandani S, Khetrapal M, Karoo K, et al. Role of Internal Jugular Vein Collapsibility Index in Predicting Post-spinal Hypotension in Pregnant Women Undergoing Cesarean Section: A Prospective Observational Study. Cureus. 2023;15

  RESULT

• Wang MK, Piticaru J, Kappel C, Mikhaeil M, Mbuagbaw L, Rochwerg B. Internal jugular vein ultrasound for the diagnosis of hypovolemia and hypervolemia in acutely ill adults: a systematic review and meta-analysis. Intern Emerg Med. 2022 Aug;17(5):1521-1532. doi: 10.1007/s11739-022-03003-y. Epub 2022 Jun 20.

  PMID: 35718838 RESULT

• Tsui BC, Wagner A, Finucane B. Regional anaesthesia in the elderly: a clinical guide. Drugs Aging. 2004;21(14):895-910. doi: 10.2165/00002512-200421140-00001.

  PMID: 15554749 RESULT

• Critchley LA. Hypotension, subarachnoid block and the elderly patient. Anaesthesia. 1996 Dec;51(12):1139-43. doi: 10.1111/j.1365-2044.1996.tb15051.x.

  PMID: 9038450 RESULT

• Hartmann B, Junger A, Klasen J, Benson M, Jost A, Banzhaf A, Hempelmann G. The incidence and risk factors for hypotension after spinal anesthesia induction: an analysis with automated data collection. Anesth Analg. 2002 Jun;94(6):1521-9, table of contents. doi: 10.1097/00000539-200206000-00027.

  PMID: 12032019 RESULT

• Priebe HJ. The aged cardiovascular risk patient. Br J Anaesth. 2000 Nov;85(5):763-78. doi: 10.1093/bja/85.5.763.

  PMID: 11094595 RESULT

MeSH Terms

Conditions

Hypotension

Condition Hierarchy (Ancestors)

Vascular Diseases; Cardiovascular Diseases

Central Study Contacts

Aylin N Gultekin, MD

CONTACT

+90 538 875 65 40; aylinnilkondiloglu@gmail.com

Guldeniz ARGUN, phD

CONTACT

+90 533 623 0405; guldargun@yahoo.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Resident Physician in Anesthesiology and Reanimation

Study Record Dates

• First Submitted: February 5, 2026
• First Posted: February 13, 2026
• Study Start: January 3, 2024
• Primary Completion: February 6, 2026
• Study Completion: February 10, 2026
• Last Updated: February 13, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)