General Anesthetic, Inflammation, Neutrophils, Spinal Aneshtesia, Total Knee Arthroplasty, White Blood Cells
Conditions
Brief summary
In total knee arthroplasty, surgical and anesthetic procedures can lead to a significant increase in systemic inflammation. This procedure is frequently performed under either general or spinal anesthesia. However, studies investigating the effect of anesthesia type on systemic inflammation have shown conflicting results. The Systemic Inflammatory Response Index (SIRI) and the Systemic Immune-Inflammation Index (SII) provide important information about the extent of systemic inflammation. This study aimed to investigate the effects of general and spinal anesthesia on perioperative changes in SII and SIRI during total knee arthroplasty. Between January 2020 and April 2025, data from 849 patients who underwent total knee arthroplasty were retrospectively reviewed. Patients received either spinal anesthesia (Group S) or general anesthesia (Group G). The groups were compared in terms of changes in perioperative SII and SIRI (ΔSII and ΔSIRI), total opioid consumption, postoperative complications, and length of hospital stay.
Interventions
OTHERThe effects of the groups on perioperative inflammation changes were compared.
Between January 2020 and April 2025, data from 849 patients who underwent total knee arthroplasty were retrospectively reviewed. Preoperative hemogram values were obtained during routine anesthesia clinic evaluation, typically one day prior to surgery. Postoperative hemogram samples were collected on the day of surgery (postoperative day 0), within 4 to 12 hours after the procedure. Blood parameters included neutrophil, lymphocyte, monocyte, and platelet counts. Based on these values, inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI) were calculated.
Sponsors
Tokat Gaziosmanpasa University
Study design
Observational model
OTHER
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged 18 to 75 years * Patients with ASA physical status I or II * Patients who have underwent total knee arthroplasty under general or spinal anesthesia
Exclusion criteria
* Patients with BMI ≥40 kg/m2 * Patients with ASA physical status ≥III * Patients with severe cardiopulmonary or metabolic disorders, coagulation disorders or active infection * Patients with known allergies or chronic steroid use * Patients with incomplete laboratory data * Patients who underwent revision total knee arthroplasty * Patients who required intraoperative conversion from spinal to general anesthesia * Patients with a history of major trauma and/or emergency surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Systemic immune inflammation index (SII) and systemic inflammatory response index (SIRI) | Preoperative hemogram values were obtained during routine anesthesia clinic evaluation, typically one day prior to surgery. Postoperative hemogram samples were collected on the day of surgery (postoperative day 0), within 4 to 12 hours after the procedur | SII = neutrophil X platelet / lymphocyte count and the SIRI = neutrophil X monocyte / lymphocyte count |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) | Preoperative hemogram values were obtained during routine anesthesia clinic evaluation, typically one day prior to surgery. Postoperative hemogram samples were collected on the day of surgery (postoperative day 0), within 4 to 12 hours after the procedur | NLR = neutrophil / lymphocyte and PLR= platelet / lymphocyte |
| Total amount of opioids consumed postoperatively | Total amount of opioids requirement within the first 24 postoperative hours | Total opioid consumption was calculated by converting all opioid doses to morphine milligram equivalents |
Countries
Turkey (Türkiye)
Outcome results
None listed