Effect of Spinal and General Anesthesia on Frontal QRS Axis in Patients Undergoing Total Knee Arthroplasty

NCT07551648 | Completed

• 1 other identifier: TDP-QRS-2025-01
• Study Type: observational
• Target: 140
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective observational study aims to compare the effects of spinal and general anesthesia on frontal QRS axis in patients undergoing elective total knee arthroplasty. Adult patients aged 18 years and older with ASA physical status I to III will be included. Participants will be grouped according to the anesthesia technique applied in routine clinical practice. Standard 12-lead electrocardiography will be obtained preoperatively and postoperatively, and frontal QRS axis values will be recorded using the automatic measurements of the ECG device. The primary objective is to evaluate the preoperative-to-postoperative change in frontal QRS axis and to compare this change between patients receiving spinal anesthesia and those receiving general anesthesia. Demographic and perioperative variables, including comorbidities, intraoperative fluid administration, blood pressure, oxygen saturation, heart rate, and tourniquet time, will also be recorded. This study is designed to provide clinical information about the potential effects of anesthesia technique on cardiac electrical activity in patients undergoing total knee arthroplasty.

Conditions

Total Knee Arthroplasty; Electrocardiographic Changes

Keywords

spinal anesthesia; general anesthesia; frontal QRS axis; electrocardiography; total knee arthroplasty

Outcome Measures

Primary Outcomes (1)

• Change in frontal QRS axis

  Preoperative-to-postoperative change in frontal QRS axis measured by standard 12-lead electrocardiography and compared between the spinal anesthesia cohort and the general anesthesia cohort.

  From preoperative assessment to within 6 hours after surgery

Secondary Outcomes (1)

• Association of perioperative variables with change in frontal QRS axis

  From preoperative assessment to within 6 hours after surgery

Study Arms (2)

Spinal Anesthesia Cohort

Patients undergoing elective total knee arthroplasty under spinal anesthesia in routine clinical practice. Preoperative and postoperative frontal QRS axis values will be recorded and analyzed.

General Anesthesia Cohort

Patients undergoing elective total knee arthroplasty under general anesthesia in routine clinical practice. Preoperative and postoperative frontal QRS axis values will be recorded and analyzed.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients undergoing elective total knee arthroplasty at a single center and managed with either spinal anesthesia or general anesthesia in routine clinical practice.

You may qualify if:

• Adults aged 18 years and older
• Patients scheduled for elective total knee arthroplasty
• ASA physical status I to III
• Patients undergoing surgery under spinal anesthesia or general anesthesia

You may not qualify if:

• Presence of a pacemaker
• Known cardiac conduction abnormality
• Technically inadequate preoperative electrocardiogram
• Active preoperative electrolyte abnormality
• Acute coronary syndrome
• Heart failure
• Bilateral knee arthroplasty performed in the same session

Sponsors & Collaborators

• Elazıg Fethi Sekin Sehir Hastanesi: lead

Study Sites (1)

Elazığ Fethi Sekin City Hospital

Elâzığ, Turkey (Türkiye)

Location

Related Publications (4)

• Duran Ö, Çetin E, Korkmaz A, et al. Effects of obesity on intraoperative frontal QRS-T angle and QT interval in laparoscopic surgery patients. Diagnostics (Basel). 2025;15(15):1962. doi:10.3390/diagnostics15151962.

  BACKGROUND

• Kaya B, Arslan H, Polat N, et al. Frontal QRS-T angle: a novel and reliable ECG parameter reflecting ventricular repolarization heterogeneity. Cardiol J. 2025;32(7):845-853. doi:10.5603/CJ.a2025.012964

  BACKGROUND

• Tercan M, Uysal S, Çelik A, et al. Impact of body mass index on frontal QRS-T angle and repolarization changes in women undergoing cesarean section with spinal anesthesia. Anatol J Cardiol. 2024;28(2):95-103. doi:10.14744/AnatolJCardiol.2024.11356263

  BACKGROUND

• Kaya A, Yılmaz A, Demirtaş S, et al. Frontal QRS-T angle as a predictor of ventricular arrhythmogenesis and repolarization heterogeneity: clinical implications. Diagnostics (Basel). 2025;15(15):1962. doi:10.3390/diagnostics15151962.

  BACKGROUND

Study Officials

• Oğuz Kağan Bulut, md

  Elazıg Fethi Sekin Sehir Hastanesi

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 20, 2026
• First Posted: April 27, 2026
• Study Start: September 4, 2025
• Primary Completion: March 3, 2026
• Study Completion: March 10, 2026
• Last Updated: April 27, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)