Comparison of retrospective effects of the low-flow anesthesia and high-flow anesthesia on hemodynamia, neutrophil lymphocyte ratio and postoperative results in tympananoplasty and myringoplasty surgeries

Introduction and Objective: The neutrophil-to-lymphocyte ratio (NLR) is increasingly utilized as a practical and cost-effective parameter for evaluating systemic inflammation and predicting the prognosis of various diseases. This study aimed to compare the effects of low-flow and high-flow anesthesia on hemodynamic parameters and NLR levels. Material and Method: With ethics committee approval, this retrospective study included 50 patients who underwent tympanoplasty or myringoplasty. Patients receiving high-flow anesthesia (Group Y) at 3 L/min and those receiving low-flow anesthesia (Group D) at 0.75 L/min were included. Data on age, sex, weight, ASA scores, hemodynamic parameters, body temperature, bispectral index (BIS), and minimum alveolar concentration (MAC) were obtained from preoperative and intraoperative anesthesia records. NLR was calculated from preoperative and postoperative complete blood count results. Sevoflurane consumption was determined retrospectively from anesthesia machine records. Results: The groups did not differ significantly in terms of age, sex, body mass index, anesthesia duration, surgical type, or complication rates. A significant postoperative increase in NLR was observed in Group Y, whereas the increase in Group D was not statistically significant. Intergroup comparison revealed that postoperative NLR was significantly lower in Group D compared to Group Y. Sevoflurane consumption was also significantly lower in the low-flow group. Conclusion: We believe that the widespread adoption of low-flow anesthesia may lead to a reduction in volatile anesthetic consumption, contributing to both ecological sustainability and cost-effectiveness, as well as a potential decrease in patients' inflammatory responses. Keywords: Anesthesia, high-flow; Anesthesia, low-flow; Neutrophil-lymphocyte ratio; Inflammation; Sevoflurane; Systemic inflammatory response.