Effects of Low-Flow and Standard-Flow Sevoflurane Anesthesia on Inflammatory Markers in Bariatric Surgery

NCT07230704 | Completed

• 2 other identifiers: ADN-LOWFLOW-202510-354
• Study Type: observational
• Target: 155
• Locations: 1 country
• Sites: 1

Brief Summary

This retrospective observational study aimed to compare the effects of low-flow and standard-flow sevoflurane anesthesia on perioperative inflammatory responses in patients undergoing laparoscopic sleeve gastrectomy for obesity. Data were obtained from the anesthesia and laboratory records of 155 adult patients who received either low-flow (1 L/min) or standard-flow (4 L/min) sevoflurane anesthesia between January 2022 and January 2025 at Adana City Training and Research Hospital. Preoperative and postoperative inflammatory markers, including C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and red cell distribution width (RDW), were recorded and compared between the two groups. Hemodynamic parameters such as mean arterial pressure and heart rate were also analyzed to assess intraoperative stability. The primary objective of the study was to evaluate the impact of anesthetic flow rate on perioperative inflammation, while the secondary objective was to assess hemodynamic stability during anesthesia. This study may contribute to a better understanding of how low-flow anesthesia influences systemic inflammatory responses and perioperative hemodynamics in morbidly obese patients undergoing bariatric surgery.

Conditions

Obesity; Inflammation; Bariatric Surgery Candidate

Keywords

Sevoflurane; Low-Flow Anesthesia; Inflammatory Markers; Hemodynamics

Outcome Measures

Primary Outcomes (3)

• Change in C-reactive protein (CRP) concentration

  Change in serum C-reactive protein (CRP) levels from preoperative baseline to postoperative 24 hours will be compared between low-flow and standard-flow sevoflurane groups.

  From preoperative baseline to postoperative 24 hours

• Change in neutrophil-to-lymphocyte ratio (NLR)

  Change in neutrophil-to-lymphocyte ratio (NLR) from preoperative baseline to postoperative 24 hours will be compared between low-flow and standard-flow sevoflurane groups.

  From preoperative baseline to postoperative 24 hours

• Change in red cell distribution width (RDW)

  Change in red cell distribution width (RDW) from preoperative baseline to postoperative 24 hours will be compared between low-flow and standard-flow sevoflurane groups.

  From preoperative baseline to postoperative 24 hours

Secondary Outcomes (2)

• Mean arterial pressure (MAP) variability

  From induction of anesthesia to end of anesthesia

• Heart rate (HR) variability

  From induction of anesthesia to end of anesthesia

Study Arms (2)

Low-flow Sevoflurane

Patients who underwent laparoscopic sleeve gastrectomy under general anesthesia with low-flow sevoflurane (fresh gas flow = 1 L/min). Data were obtained retrospectively from hospital records.

Standard-flow Sevoflurane

Patients who underwent laparoscopic sleeve gastrectomy under general anesthesia with standard-flow sevoflurane (fresh gas flow = 4 L/min). Data were obtained retrospectively from hospital records.

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Retrospective analysis of 155 adult patients who underwent laparoscopic sleeve gastrectomy under general anesthesia between January 2022 and January 2025 at Adana City Training and Research Hospital. Patients were grouped according to the fresh gas flow rate used during anesthesia (low-flow vs. standard-flow sevoflurane).

You may qualify if:

• Adult patients aged 18-60 years
• Underwent laparoscopic sleeve gastrectomy under general anesthesia
• Received low-flow or standard-flow sevoflurane anesthesia
• ASA physical status I-III
• Complete perioperative records available

You may not qualify if:

• Conversion to open surgery
• Incomplete or missing data
• Significant comorbidities (e.g., severe cardiac, hepatic, or renal dysfunction)
• Perioperative complications unrelated to anesthesia
• Age \<18 or \>60 years

Sponsors & Collaborators

• Adana City Training and Research Hospital: lead

Study Sites (1)

Adana City Training and Research Hospital

Adana, Adana, 010650, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Obesity; Inflammation

Condition Hierarchy (Ancestors)

Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Pathologic Processes

Study Officials

• Ugur serkan Citilcioglu, MD

  Adana City Training and Research Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator, Department of Anesthesiology

Study Record Dates

• First Submitted: November 13, 2025
• First Posted: November 17, 2025
• Study Start: January 1, 2022
• Primary Completion: January 31, 2025
• Study Completion: January 31, 2025
• Last Updated: November 17, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)