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Korean J Anesthesiol > Epub ahead of print
DOI: https://doi.org/10.4097/kja.d.19.00022    [Epub ahead of print]
Published online May 17, 2019.
The effect of anesthetic techniques on neutrophil to lymphocyte ratio in patients undergoing infraumbilical surgeries
SS Nethra, H Chaithali, K Sudheesh, D Devikarani, RS Raghavendra Rao, GM Chethana
Department of Anesthesia Bangalore Medical College and Research Institute Bangalore
Corresponding author:  K Sudheesh,
Email: drsudhi@rediffmail.com
Received: 18 January 2019   • Revised: 28 March 2019   • Accepted: 16 May 2019
Abstract
Background
Neutrophil/lymphocyte ratio (NLR) is a simple marker in peripheral blood and is used as a parameter to assess inflammatory response and physiological stress during perioperative period. Anesthetic technique may influence NLR, thereby modulating inflammatory response and surgical outcome. The aim of this study was to evaluate the relationship between blood NLR and anesthetic techniques in patients undergoing infraumbilical surgeries.
Methods
Institutional Ethical Committee clearance and patient consent was taken. Prospective randomized double-blinded study was conducted from July 2017–November 2017, involving 80 ASA 1 and 2 patients, aged 18–60 years scheduled for elective infraumbilical surgeries. Patients refusal, those with ongoing acute infections, electrolyte abnormalities were excluded from study. The patients were randomized into 2 groups, Group G receiving general anesthesia and Group S receiving spinal anesthesia as per standardized protocol. In both groups, differential counts of leukocytes with NLR of peripheral blood were obtained preoperatively on the morning of surgery, 2 hours after surgery and 24 hours after surgery. The data was noted and analysed using appropriate statistical tests.
Results
Demographic parameters and basal Total Leukocyte Count (TLC) and NLR were comparable. TLC and NLR were significantly higher in Group G compared to Group S postoperatively. The post-operative increase in TLC and NLR from basal values was significantly higher in Group G compared to Group S.
Conclusions
General anesthesia is associated with greater increases in TLC and NLR compared to sub arachnoid block.
Key Words: General; Lymphocytes; Neutrophils; Spinal anesthesia


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