Inflammatory Response Under Spinal vs General Anesthesia in PCNL: NLR, RDW, LAR.

NCT07205224 | Completed

• 1 other identifier: EFSH-ANES-2025-09-PERCUTANE
• Study Type: observational
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

This observational study compares the effects of spinal versus general anesthesia on the perioperative systemic inflammatory response in adults undergoing PCNL. Routine clinical laboratory values (NLR, RDW, LAR) obtained preoperatively and postoperatively will be recorded to evaluate between-group and within-group changes. No additional blood sampling will be performed beyond standard care.

Conditions

Nephrolithiasis; Postoperative Inflammation

Keywords

Percutaneous Nephrolithotomy; PCNL; Spinal Anesthesia; General Anesthesia; Inflammatory Response; Neutrophil-to-Lymphocyte Ratio (NLR); Red Cell Distribution Width (RDW); Lactate-to-Albumin Ratio (LAR)

Outcome Measures

Primary Outcomes (1)

• Change in Neutrophil-to-Lymphocyte Ratio (ΔNLR)

  Difference in neutrophil-to-lymphocyte ratio (NLR) between preoperative (≤6 hours before surgery) and postoperative (6-24 hours after surgery) blood samples in spinal vs general anesthesia groups.

  Baseline (≤6 hours preoperative) and 24 hours postoperatively

Secondary Outcomes (3)

• Change in Red Cell Distribution Width (ΔRDW)

  Baseline (≤6 hours preoperative) and 24 hours postoperatively

• Change in Lactate-to-Albumin Ratio (ΔLAR)

  aseline (≤6 hours preoperative) and 24 hours postoperatively

• Postoperative Complications

  From surgery until hospital discharge (up to 7 days)

Study Arms (2)

Spinal Anesthesia Cohort

Adult patients (≥18 years, ASA I-III) undergoing percutaneous nephrolithotomy (PCNL) under spinal anesthesia. Routine perioperative laboratory values (NLR, RDW, LAR) will be recorded preoperatively and postoperatively.

Other: Anesthesia Type

General Anesthesia Cohort

Adult patients (≥18 years, ASA I-III) undergoing percutaneous nephrolithotomy (PCNL) under general anesthesia. Routine perioperative laboratory values (NLR, RDW, LAR) will be recorded preoperatively and postoperatively.

Other: Anesthesia Type

Interventions

Anesthesia Type OTHER

Patients receive either spinal or general anesthesia according to routine clinical decision-making. No investigational drug or device is administered.

General Anesthesia Cohort; Spinal Anesthesia Cohort

Eligibility Criteria

• Age: 18 Years - 99 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients (≥18 years, ASA I-III) scheduled for percutaneous nephrolithotomy (PCNL) at a single tertiary care center. Eligible patients will be assigned to spinal or general anesthesia groups based on routine clinical decision-making. Routine perioperative laboratory values (NLR, RDW, LAR) will be collected preoperatively and postoperatively.

You may qualify if:

• Age ≥18 years
• ASA physical status I-III
• Scheduled for percutaneous nephrolithotomy (PCNL)
• Provided informed consent

You may not qualify if:

• Active infection or sepsis
• Known malignancy
• Chronic inflammatory or autoimmune disease (e.g., rheumatoid arthritis, systemic lupus erythematosus)
• Current immunosuppressive therapy
• Pregnancy

Sponsors & Collaborators

• Sevim Şenol Karataş: lead

Study Sites (1)

Elazığ Fethi Sekin City Hospital

Elâzığ, Merkez, 23200, Turkey (Türkiye)

Location

Related Publications (3)

• Sankar K, Anand K, Ramani S, Gayathri B. A Randomized Control Trial to Compare Hemodynamic Parameters of Patients Undergoing Percutaneous Nephrolithotomy Under Combined Spinal-Epidural and General Anesthesia in a Tertiary Hospital. Local Reg Anesth. 2023 May 18;16:41-49. doi: 10.2147/LRA.S410510. eCollection 2023.

  PMID: 37223489 BACKGROUND

• Wongyingsinn M, Kohmongkoludom P, Trakarnsanga A, Horthongkham N. Postoperative clinical outcomes and inflammatory markers after inguinal hernia repair using local, spinal, or general anesthesia: A randomized controlled trial. PLoS One. 2020 Nov 30;15(11):e0242925. doi: 10.1371/journal.pone.0242925. eCollection 2020.

  PMID: 33253306 BACKGROUND

• Indra Rachman R, Birowo P, Nurullah G, Cho PSY, Atmoko W, Widyahening IS, Rasyid N. General versus spinal anesthesia in percutaneous nephrolithotomy: A systematic review and meta-analysis. F1000Res. 2023 Nov 1;12:281. doi: 10.12688/f1000research.124704.2. eCollection 2023.

  PMID: 38618023 BACKGROUND

Related Links

• Elazığ Fethi Sekin City Hospital, Department of Anesthesiology and Reanimation

MeSH Terms

Conditions

Nephrolithiasis

Condition Hierarchy (Ancestors)

Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Urolithiasis; Male Urogenital Diseases

Study Officials

• Sevim Şenol Karataş

  Elazığ Fethi Sekin City Hospital, Department of Anesthesiology and Reanimation

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Principal Investigator,

Study Record Dates

• First Submitted: September 22, 2025
• First Posted: October 3, 2025
• Study Start: September 22, 2025
• Primary Completion: October 22, 2025
• Study Completion: October 22, 2025
• Last Updated: November 26, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)