The effects of general and spinal anesthesia on biochemical and inflammatory parameters and postoperative blood transfusion in patients undergoing total knee arthroplasty

Objective: This study aims to compare the effects of general and spinal anesthesia on hemogram parameters, biochemical inflammatory markers, and postoperative blood transfusion requirements in total knee arthroplasty surgeries. Materials and Methods: A total of 157 patients who underwent surgery at Afyonkarahisar Health Sciences University between 2022 and 2024 were included in the study. The patients were retrospectively evaluated and divided into two groups: those who received general anesthesia (n = 56) and those who received spinal anesthesia (n = 101). Preoperative and postoperative (day 0 and day 1) hemogram parameters, biochemical inflammatory marker levels, and postoperative transfusion data were compared. Results: On postoperative day 0, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were significantly higher in the general anesthesia group, while lymphocyte, monocyte, basophil, and eosinophil levels were significantly higher in the spinal anesthesia group. On day 1, white blood cell count, neutrophil, monocyte, and mean platelet volume were significantly higher in the spinal anesthesia group, whereas the platelet-to-lymphocyte ratio remained significantly higher in the general anesthesia group. Among patients who received transfusion, the amount of erythrocyte transfusion was higher in the spinal anesthesia group. Conclusion: The type of anesthesia affects inflammatory response and hematological parameters following total knee arthroplasty. Therefore, when selecting the anesthesia method, not only intraoperative factors but also postoperative biochemical changes and transfusion requirements should be considered.