Unilateral vs. Bilateral Spinal Anesthesia for Hip Replacement in Older Adults

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

In this randomized study, 74 older adults undergoing elective total hip arthroplasty are assigned to receive either unilateral or bilateral spinal anesthesia. Hemodynamic parameters such as cardiac output, stroke volume, and vascular resistance are continuously monitored using PRAM-based MostCare software through a radial arterial line. The trial also records intraoperative fluid requirements and vasopressor use to compare cardiovascular stability between the two anesthesia techniques. Standard sedation is given before spinal anesthesia, and eligibility requires adequate arterial anatomy and consent. Findings will inform whether unilateral spinal anesthesia may offer cardiovascular advantages in this high-risk population.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Adults aged 65 years and older.
2. Patients scheduled for elective total hip arthroplasty.
3. Patients with an American Society of Anesthesiologists (ASA) physical status classification of II, III, or IV.
4. Patients with a Glasgow Coma Scale (GCS) score of 13-15 who are conscious and able to cooperate.
5. Patients with suitable peripheral arterial anatomy for PRAM monitoring.
6. Patients who provide written informed consent to participate in the study.
7. Patients without any clinical contraindication to spinal anesthesia. -

Exclusion Criteria:

1. Glasgow Coma Scale (GCS) score \<13.
2. Age below 65 years.
3. History of previous major neurosurgical intervention.
4. Anatomical abnormality, vascular defect, or infection at the site intended for arterial catheter placement for PRAM monitoring.
5. Severe spinal deformity (e.g., severe scoliosis, previous spinal fusion surgery, or spinal trauma).
6. Current anticoagulant therapy or coagulopathy (INR \>1.5 or platelet count \<75,000/mm³).
7. Presence of skin infection or systemic infection/sepsis.
8. Severe hypovolemia or decompensated cardiac disease in which spinal anesthesia is contraindicated.
9. Known allergy or hypersensitivity to local anesthetics or sedative agents.
10. Local infection or wound at the planned spinal puncture site.
11. Clinical contraindication to spinal anesthesia (e.g., increased intracranial pressure, septicemia, or severe hypotension). -

Where it's running

• Kayseri City Hospital
  Kayseri, Kayseri, Turkey (Türkiye) Recruiting

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.