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
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
Did not provide written informed consent
Undergoing emergency surgery
Body mass index (BMI) ≥40 kg/m²
Receiving angiotensin-converting enzyme (ACE) inhibitors
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.
Cohort
Prospective
Not applicable- observational study
Other interventionNot applicable- observational study
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.
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