Clinical trial NCT06984315: Effects of Anesthesia Type on Inflammatory Response
Official title: Spinal Anesthesia Mitigates Systemic Inflammatory Response Compared to General Anesthesia in Total Knee Arthroplasty: A Retrospective Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Spinal Aneshtesia
General Anesthetic
Inflammation
Neutrophils
Total Knee Arthroplasty
White Blood Cells
Lead sponsor: Tokat Gaziosmanpasa University
Sponsor class: OTHER
First posted: 2025-05-22
Enrollment: 849
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Between January 2020 and April 2025, data from 849 patients who underwent total knee arthroplasty were retrospectively reviewed.

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.


Eligibility criteria: 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

Primary outcomes:
measure: Systemic immune inflammation index (SII) and systemic inflammatory response index (SIRI)
timeFrame: 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
Secondary outcomes:
measure: Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR)
timeFrame: 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
measure: Total amount of opioids consumed postoperatively
timeFrame: Total amount of opioids requirement within the first 24 postoperative hours
Other outcomes:
Locations:
city: Tokat
country: Turkey
facility: Tokat Gaziosmanpasa University
Study officials:
References: