Comparison of the effect of erector spinae plane block for postoperative analgesia on neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients operated for breast cancer

Female breast cancer is the most frequently diagnosed cancer worldwide. It has been shown that recurrence and metastasis seen after breast cancer surgery are related to the immune response of the host. Anesthetic agents modulate the surgical stress response or directly impair the functions of immune system cells. In our study, we aimed to compare the effects of nonsteroidal anti-inflammatory drugs and erector spinae plane block, which are among the methods we use for postoperative analgesia, on the neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients undergoing breast cancer surgery in Tekirdag Namık Kemal University Faculty of Medicine, Department of Anesthesiology and Reanimation. One hundred female patients aged 18-75 years, scheduled for unilateral breast cancer surgery, and who agreed to participate were included in our study. These cases were divided into two groups of 50 people according to the analgesia method: Those with erector spinae plane block (Group E) and those who were administered nonsteroidal anti-inflammatory drugs (Group N). The values of white blood cell, leukocyte, lymphocyte, thrombocyte, haemoglobin, hematocrit, mean corpuscular volume and mean platelet volume were recorded in the haemogram samples taken before the operation and at the 2nd hour postoperatively. According to the results, preoperative and postoperative neutrophil/lymphocyte ratio and platelet/lymphocyte ratio values were calculated and recorded. Postoperative 0th, 2nd, 4th and 6th hour visual analogue scale scores of the patients were recorded. While white blood cell, leukocyte, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were statistically higher in both groups in the postoperative period, lymphocyte, thrombocyte, haemoglobin and hematocrit values were found to be significantly lower. No statistically significant difference was foundwhen the preoperative and postoperative measurement changes of the laboratory parameters between the groups were compared. Postoperative 0th, 2nd, 4th and 6th hour VAS scores were statistically significantly lower in Group E. The change in VAS score at the 4th and 6th hours compared to the postoperative 0th hour was found to be statistically significantly higher in Group N. As a result, we concluded that when erector spinae plane block and nonsteroidal anti-inflammatory drug use were compared in the managing postoperative analgesia in breast cancer surgery, their effects on neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were not superior to each other. However, erector spinae plane block was superior for adequate pain control.