Comparison of the effects of general and spinal anesthesia on the systemic immune inflammatory index in patients under knee prosthetic surgery

Previous studies comparing the general anesthesia with spinal anesthesia in patients undergoing total knee arthroplasty (TKA) have presented conflicting results regarding the complications. While some of the studies found a lower complication rate in patients who received spinal anesthesia during TKA compared to those who received general anesthesia, some showed that the venous thromboembolism rate of spinal anesthesia increased, and some showed that the anesthesia technique did not change the short-term complication rates. In this retrospective study, we aimed to compare the effects of general and spinal anesthesia techniques applied during surgery to the patients, over age of 18 who underwent a knee prosthesis surgery and registered in the hospital automation system, on the inflammation evaluated with the systemic immune inflammatory index (SIII), which is considered a marker of systemic inflammatory response. A total of 481 of patients aged 18 years and older who underwent TKA under general and spinal anesthesia and had American Society of Anesthesiologists (ASA) scores I, II and III; who did not have chronic inflammatory disease, did not use antiinflammatory drugs and whose data could be accessed were included in this retrospective study. The patients were divided into two groups as spinal anesthesia (Group SA, n:381) and general anesthesia (Group GA, n:100). Demographic data, clinical findings, laboratory findings, systemic immune inflammatory index (SIII) value obtained with Neutrophil x Platelet/Lymphocyte, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were recorded. Data were compared according to anesthesia type. In patients who underwent spinal anesthesia compared to those underwent general anesthesia during TKA, the inflammatory markers SIII and NLR values were found to be significantly higher on the postoperative 1st day (p0.05). Although general anesthesia in TKA showed better results for SIII, which we used to evaluate the systemic inflammation response compared to the spinal anesthesia and which is the basis of our study, both anesthesia have different positive effects. Key words: total knee arthroplasty, general anesthesia, spinal anesthesia, systemic immune inflammatory index