Department of Anesthesiology, Victoria Hospital, Bangalore Medical College and Research Institute, Bangalore, India.
Korean J Anesthesiol. 2019 Oct;72(5):458-465. doi: 10.4097/kja.d.19.00022. Epub 2019 May 17.
Neutrophil to lymphocyte ratio (NLR) is a simple marker in peripheral blood and is used to assess inflammatory response and physiological stress during the peri-operative period. Anesthetic technique may influence NLR, thereby modulating the inflammatory response and surgical outcomes. The study aimed to evaluate the relationship between blood NLR and anesthetic techniques in patients undergoing infraumbilical surgeries.
Institutional ethical committee approval and patient consent were obtained. A prospective randomized double- blinded study was conducted between July 2017 and November 2017, involving 80 patients classified as the American Society of Anesthesiologists grade 1 and 2, aged 18-60 years, and scheduled for elective infraumbilical surgeries. Unwilling and those with infections were excluded. The patients were randomly divided into two groups: Group G (general anesthesia) and Group S (spinal anesthesia) as per the standardized protocol. Differential counts of leukocytes and NLR in the peripheral blood were obtained pre-operatively on the morning of surgery and at 2 h and 24 h after surgery in both the groups. The data were analyzed using appropriate statistical tests.
The demographic parameters, basal total leukocyte count (TLC), and NLR were comparable between the groups. TLC and NLR were significantly higher in Group G as compared to that in Group S post-operatively. The post-operative rise in TLC and NLR from the basal values was significantly higher in Group G as compared to that in Group S.
General anesthesia was associated with a greater increase in TLC and NLR when compared with spinal anesthesia.
中性粒细胞与淋巴细胞比值（NLR）是外周血中的一个简单标志物，用于评估围手术期的炎症反应和生理应激。麻醉技术可能会影响 NLR，从而调节炎症反应和手术结果。本研究旨在评估接受下腹部手术患者的血液 NLR 与麻醉技术之间的关系。
获得机构伦理委员会批准和患者同意。在 2017 年 7 月至 2017 年 11 月期间进行了一项前瞻性随机双盲研究，共纳入 80 例美国麻醉医师协会（ASA）分级 1 级和 2 级、年龄 18-60 岁、拟行择期下腹部手术的患者。排除不愿意和有感染的患者。患者按照标准化方案随机分为两组：G 组（全身麻醉）和 S 组（椎管内麻醉）。两组患者均于术前清晨、术后 2 h 和 24 h 采集外周血白细胞分类计数和 NLR。采用适当的统计检验对数据进行分析。
两组患者的人口统计学参数、基础总白细胞计数（TLC）和 NLR 均无差异。与 S 组相比，G 组术后 TLC 和 NLR 明显升高。与 S 组相比，G 组术后从基础值升高的 TLC 和 NLR 明显更高。
与椎管内麻醉相比，全身麻醉后 TLC 和 NLR 增加更明显。
