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NCT Number: NCT06679933

Relationship Between Grip Strength and Intraoperative Hemodynamic Parameters

In geriatric anesthesia, hand grip strength is used as an important biomarker to evaluate the general health status of elderly patients. Hand grip strength is considered an indicator of various factors, such as muscle function, physical endurance, nutritional status, and frailty, and can be helpful in geriatric anesthesia practice to predict patients' response to anesthesia and determine their risk.

Hand grip strength is used as an important parameter in the pre-anesthesia evaluation of elderly patients. Low grip strength has been associated with postoperative complications (e.g., infection, pulmonary complications, prolonged hospitalization) and worse outcomes.Weak hand grip strength is related to the patient's degree of frailty. Frail patients may be less resistant to stress and respond more negatively to anesthesia.

One of the most important of these responses is intraoperative hypotension, and it is especially common in elderly patients. Since hypotension has possible adverse effects in the postoperative period, it is necessary to evaluate elderly patients in more detail during the preoperative evaluation in order to predict this and take the necessary precautions. Hand grip strength has been found to be associated with cardiovascular system health. With this study, the investigators wanted to evaluate whether measuring hand grip strength during preoperative evaluation would help evaluate the risk of intraoperative hypotension.

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Key information

Conditions

Hypotension During Surgery Geriatric Patient Hand Grip Strength

Age range

65 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Kırşehir Ahi Evran University Research and Education Hospital

Kırşehir, 40100, Turkey (Türkiye)

About this study

One of the most common intraoperative complications following spinal anesthesia is hypotension, which can occur in 16-33% of patients. In non-cardiac surgeries, there is a significant increase in postoperative major cardiac and cerebrovascular events within 30 days, parallel to the decrease in intraoperative mean arterial pressure within hypotensive limits. While there are different threshold values related to mean arterial pressure that can lead to organ damage in the literature, high-quality studies have found this value to be approximately 65 mmHg. However, in elderly patient groups, hypertension is frequently seen due to age-related arterial degeneration, which raises the perfusion thresholds of vital organs. In this context, rather than using a fixed threshold value, the variation of mean arterial pressure may provide a healthier perspective.

The risk of hypotension increases with physiological changes in the elderly, and the more widespread use of spinal anesthesia compared to general anesthesia in older adults underscores the need for better identification of risk factors.

Hand grip strength is a frequently used muscle strength measurement method in sports medicine and geriatric patient groups. It is usually measured in kg or lb with the help of a dynamometer. It provides valuable information in both rehabilitation studies and sarcopenia evaluation. Sarcopenia, or muscle wasting, is associated with frailty in geriatric patients and is one of the important indicators of cardiovascular health. For this reason, the deterioration of cardiovascular health with aging and the increase in the risk of hypotension, one of the side effects of anesthesia, can be predicted by muscle strength evaluation. The aim of our study is to examine whether muscle strength assessment is associated with intraoperative hypotension.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients who are 65 years and older
  • Patients undergoing elective surgery
  • Patients suitable for spinal anesthesia

Exclusion criteria

  • Presence of anatomical or neurological dysfunction of the upper extremity
  • Failed spinal anesthesia
  • Failure to measure hand grip strength accurately

Treatment and study plan

Hand grip strength measurament

Other

That intervention includes making the patient sit down and rest for 5 minutes on a comfortable chair. Then make them handle a hand dynamometer with their dominant hand and ask them to squeeze it with all of their effort. Repeat that squeeze three times with 2-minute intervals. The highest number recorded on the dynamometer is the hand grip strength of the patient.

Primary outcomes

  1. Is low grip strength related with more hypotension?

    Time frame: During the surgery

    We examined whether low hand grip strength was associated with the frequency of intraoperative hypotension.

Secondary outcomes

  1. Is there any difference in blood pressure changes between patients with low hand grip strength and patients with high hand grip strength.

    Time frame: During the surgery

    Male and female participants were evaluated in two separate groups, and a threshold value was determined for hand grip strength in accordance with the literature. The temporal change in blood pressures of patients below and above this threshold value was examined and whether there was a difference.

Sponsors and collaborators

Lead sponsor

Kirsehir Ahi Evran Universitesi

Other

Registry information

Official study title

Relationship Between Grip Strength and Intraoperative Hemodynamic Parameters in Geriatric Patients Undergoing Spinal Anesthesia

Important dates

Study start
2022
Primary completion
2023
Study completion
2023
First posted
Nov 8, 2024
Registry last updated
Nov 8, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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