Patients are at risk for hemodynamic instability both during and after surgery, as it is an independent predictor of long-term patient morbidity and length of hospital stay. The development of hemodynamic instability is caused by a number of factors. When these risk factors are prevented or treated, patients may experience less hemodynamic instability during pelvic surgery, as well as the morbidity and mortality that come with it in both spinal and general anesthesia.

The objective of this study was to evaluate the factors that affect the hemodynamic stability and evaluate the effectiveness of different management strategies employed to maintain hemodynamic stability during spinal and general anesthesia.

Inclusion Criteria:

• Adult patients aged 18 years and older.
• ASA (American Society of Anesthesiologists) physical status classification I and II.
• Patients scheduled for elective pelvic surgery.
• Can give informed consent or has a legal representative to give consent.
• There are no contraindications to spinal or general anesthesia based on preoperative assessment (e.g, severe cardiovascular disease, no previous history of adverse anesthetic reactions).

Exclusion Criteria:

• Age below 18 years.
• Emergency procedures or that require immediate intervention.
• Pregnancy or breastfeeding status.
• Conditions such as spinal cord disease and severe coagulopathy that are recognized contraindications to spinal or general anesthesia.
• ASA physical status classification III and above.
• History of severe adverse reactions to anesthesia or known allergy to anesthetic agents.
• Concurrent involvement in additional clinical trials that could have an impact on the treatment of anesthesia or hemodynamic results.
• Individuals with substantial comorbidities (such as uncontrolled hypertension or heart failure) that might complicate hemodynamic responses.

Intraoperatively hemodunamic instability during spinal and general anesthesia was adressed and also evaluate its management.