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NCT Number: NCT06984315

Effects of Anesthesia Type on Inflammatory Response

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.

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Key information

Conditions

Spinal Aneshtesia General Anesthetic Inflammation Neutrophils Pathologic Processes Pathological Conditions, Signs and Symptoms Total Knee Arthroplasty White Blood Cells

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Tokat Gaziosmanpasa University

Tokat Province, 60100, Turkey (Türkiye)

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

The effects of the groups on perioperative inflammation changes were compared.

Other

Between January 2020 and April 2025, data from 849 patients who underwent total knee arthroplasty were retrospectively reviewed. 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 procedure. Blood parameters included neutrophil, lymphocyte, monocyte, and platelet counts. Based on these values, inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI) were calculated.

Primary outcomes

  1. Systemic immune inflammation index (SII) and systemic inflammatory response index (SIRI)

    Time frame: 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 outcomes

  1. Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR)

    Time frame: 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

  2. Total amount of opioids consumed postoperatively

    Time frame: 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

Sponsors and collaborators

Lead sponsor

Tokat Gaziosmanpasa University

Other

Registry information

Official study title

Spinal Anesthesia Mitigates Systemic Inflammatory Response Compared to General Anesthesia in Total Knee Arthroplasty: A Retrospective Study

Important dates

Study start
2020
Primary completion
2025
Study completion
2025
First posted
May 22, 2025
Registry last updated
May 25, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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