Effects of Anesthesia Type on Inflammatory Response

Completed

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

• Registration Number: NCT06984315
• Lead Sponsor: Tokat Gaziosmanpasa University

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.

Detailed Description

Not available

Study Timeline

• Study Start: 2020-01-01
• Primary Completion: 2025-04-01
• Status Verified: 2025-05
• Study Completion: 2025-05-10
• Study First Submitted: 2025-05-14
• Study First Submitted QC: 2025-05-14
• Last Update Submitted: 2025-05-21
• Study First Posted: 2025-05-22
• Last Update Posted: 2025-05-25

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 849

Inclusion Criteria

• 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

Exclusion Criteria

• 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

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Systemic immune inflammation index (SII) and systemic inflammatory response index (SIRI)	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	SII = neutrophil X platelet / lymphocyte count and the SIRI = neutrophil X monocyte / lymphocyte count

Secondary Outcome Measures

Name	Time	Method
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	NLR = neutrophil / lymphocyte and PLR= platelet / lymphocyte
Total amount of opioids consumed postoperatively	Total amount of opioids requirement within the first 24 postoperative hours	Total opioid consumption was calculated by converting all opioid doses to morphine milligram equivalents

Trial Locations

Locations (1)

Tokat Gaziosmanpasa University; 🇹🇷 Tokat, Turkey