Spinal Versus General Anesthesia and Inflammatory Response Measured by Delta Neutrophil Index in Total Knee Arthroplasty: An Observational Study

NCT07214558 | Completed

• 1 other identifier: EFSH-ANES-2025-09-DELTANEUTROP
• Study Type: observational
• Target: 84
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to compare the effects of spinal versus general anesthesia on the inflammatory response measured by Delta Neutrophil Index (DNI) in patients undergoing total knee arthroplasty. The study is prospective and observational. A total of at least 84 patients will be included, with anesthesia type determined according to routine clinical practice. Preoperative and postoperative blood tests will be analyzed, and no additional blood samples will be required.

Conditions

Inflammatory Response in Total Knee Arthroplasty

Keywords

Total Knee Arthroplasty; Spinal Anesthesia; General Anesthesia; Delta Neutrophil Index; Inflammatory Response

Outcome Measures

Primary Outcomes (1)

• Change in Delta Neutrophil Index (DNI)

  Difference in DNI values measured preoperatively and postoperatively in patients undergoing total knee arthroplasty under spinal versus general anesthesia.

  From baseline (preoperative) to 24 hours postoperative.

Secondary Outcomes (5)

• Neutrophil Count

  Preoperative to 24 hours postoperative.

• Perioperative Complications

  Intraoperative and during hospital stay (up to 7 days).

• Operative Time

  Intraoperative period.

• Lymphocyte Count

  Preoperative to 24 hours postoperative.

• Neutrophil-to-Lymphocyte Ratio (NLR)

  Preoperative to 24 hours postoperative.

Study Arms (2)

Spinal Anesthesia Group

Patients undergoing total knee arthroplasty under spinal anesthesia. The choice of anesthesia is based on clinical decision-making in routine practice.

Other: Routine Clinical Anesthesia Practice

General Anesthesia Group

Patients undergoing total knee arthroplasty under general anesthesia. The choice of anesthesia is based on clinical decision-making in routine practice.

Other: Routine Clinical Anesthesia Practice

Interventions

Routine Clinical Anesthesia Practice OTHER

Patients undergoing total knee arthroplasty will receive either spinal or general anesthesia as determined by routine clinical practice and the attending anesthesiologist's decision. Investigators will not influence the choice of anesthesia method.

General Anesthesia Group; Spinal Anesthesia Group

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 undergoing elective total knee arthroplasty at Elazig Fethi Sekin City Hospital, Department of Anesthesiology and Reanimation.

You may qualify if:

• Patients scheduled for total knee arthroplasty
• Age ≥ 18 years
• ASA physical status classification I-III

You may not qualify if:

• Active infection
• Hematologic disease (e.g., leukemia, aplastic anemia)
• Autoimmune or chronic inflammatory disease
• Use of corticosteroids or immunosuppressive drugs
• Malignancy
• Acute trauma or sepsis
• Pregnancy

Sponsors & Collaborators

• Elazıg Fethi Sekin Sehir Hastanesi: lead

Study Sites (1)

University of Health Sciences, Elazığ Fethi Sekin City Hospital

Elâzığ, Merkez, 23200, Turkey (Türkiye)

Location

Related Publications (2)

• Bozan MB, Yazar FM, Kale IT, Yuzbasioglu MF, Boran OF, Azak Bozan A. Delta Neutrophil Index and Neutrophil-to-Lymphocyte Ratio in the Differentiation of Thyroid Malignancy and Nodular Goiter. World J Surg. 2021 Feb;45(2):507-514. doi: 10.1007/s00268-020-05822-6. Epub 2020 Oct 16.

  PMID: 33067685 BACKGROUND

• Nahm CH, Choi JW, Lee J. Delta neutrophil index in automated immature granulocyte counts for assessing disease severity of patients with sepsis. Ann Clin Lab Sci. 2008 Summer;38(3):241-6.

  PMID: 18715852 BACKGROUND

Related Links

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

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: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: September 22, 2025
• First Posted: October 9, 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)