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

Recruiting

• Conditions: Nephrolithiasis; Postoperative Inflammation

• Registration Number: NCT07205224
• Lead Sponsor: Sevim Şenol Karataş

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.

Detailed Description

The study will be conducted at the Department of Anesthesiology and Reanimation, Elazığ Fethi Sekin City Hospital, among adult patients scheduled for PCNL (ASA I-III). The anesthesia type (spinal vs general) is determined by clinical requirements; investigators do not influence this choice.

Sampling windows:

Preoperative: within ≤6 hours before surgery

Postoperative: first sample obtained within 6-24 hours after surgery Parameters: NLR (neutrophil/lymphocyte), RDW, LAR; plus age, sex, ASA class, operative time, and in-hospital complications.

Statistics: Normality testing; between-group comparisons by independent t-test or Mann-Whitney U; within-group by paired t-test or Wilcoxon; categorical by chi-square; p\<0.05 significant. Power considerations target ≥45 per group (total ≥90). No extra biospecimens will be collected beyond routine care.

Study Timeline

• Study Start: 2025-09-22
• Study First Submitted: 2025-09-22
• Status Verified: 2025-10
• Study First Submitted QC: 2025-10-02
• Last Update Submitted: 2025-10-02
• Study First Posted: 2025-10-03
• Last Update Posted: 2025-10-03
• Primary Completion: 2025-10-22
• Study Completion: 2025-10-22

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 90

Inclusion Criteria

Age ≥18 years

ASA physical status I-III

Scheduled for percutaneous nephrolithotomy (PCNL)

Provided informed consent

Exclusion Criteria

Active infection or sepsis

Known malignancy

Chronic inflammatory or autoimmune disease (e.g., rheumatoid arthritis, systemic lupus erythematosus)

Current immunosuppressive therapy

Pregnancy

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Change in Neutrophil-to-Lymphocyte Ratio (ΔNLR)	Baseline (≤6 hours preoperative) and 24 hours postoperatively	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.

Secondary Outcome Measures

Name	Time	Method
Change in Red Cell Distribution Width (ΔRDW)	Baseline (≤6 hours preoperative) and 24 hours postoperatively	Difference in RDW values between preoperative (≤6 hours before surgery) and postoperative (6-24 hours after surgery) blood samples in spinal vs general anesthesia groups.
Change in Lactate-to-Albumin Ratio (ΔLAR)	aseline (≤6 hours preoperative) and 24 hours postoperatively	Difference in LAR values between preoperative (≤6 hours before surgery) and postoperative (6-24 hours after surgery) blood samples in spinal vs general anesthesia groups.
Postoperative Complications	From surgery until hospital discharge (up to 7 days)	Occurrence of any PCNL-related complications (e.g., bleeding, infection) during index hospitalization.

Trial Locations

Locations (1)

Elazığ Fethi Sekin City Hospital; Elâzığ, Merkez, Turkey (Türkiye)