Effects of Anesthesia Type on Inflammatory Response

NCT06984315 | Completed

• 1 other identifier: 25-MOBAEK-160
• Study Type: observational
• Target: 849
• Locations: 1 country
• Sites: 1

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.

Conditions

Spinal Aneshtesia; General Anesthetic; Inflammation; Neutrophils; Total Knee Arthroplasty; White Blood Cells

Outcome Measures

Primary Outcomes (1)

• Systemic immune inflammation index (SII) and systemic inflammatory response index (SIRI)

  SII = neutrophil X platelet / lymphocyte count and the SIRI = neutrophil X monocyte / lymphocyte count

  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

Secondary Outcomes (2)

• 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

• Total amount of opioids consumed postoperatively

  Total amount of opioids requirement within the first 24 postoperative hours

Study Arms (2)

Group S

Underwent total knee arthroplasty under spinal anesthesia

Other: The effects of the groups on perioperative inflammation changes were compared.

Group G

Underwent total knee arthroplasty under general anesthesia

Other: The effects of the groups on perioperative inflammation changes were compared.

Interventions

The effects of the groups on perioperative inflammation changes were compared. OTHER

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.

Group G; Group S

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Between January 2020 and April 2025, data from 849 patients who underwent total knee arthroplasty were retrospectively reviewed.

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Tokat Gaziosmanpasa University: lead

Study Sites (1)

Tokat Gaziosmanpasa University

Tokat Province, 60100, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Inflammation

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant professor

Study Record Dates

• First Submitted: May 14, 2025
• First Posted: May 22, 2025
• Study Start: January 1, 2020
• Primary Completion: April 1, 2025
• Study Completion: May 10, 2025
• Last Updated: May 25, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: SAP

Locations

TU (1)