Korean J Anesthesiol.  2019 Oct;72(5):458-465. 10.4097/kja.d.19.00022.

The effect of anesthetic techniques on neutrophil to lymphocyte ratio in patients undergoing infraumbilical surgeries

  • 1Department of Anesthesiology, Victoria Hospital, Bangalore Medical College and Research Institute, Bangalore, India. drsudhi@rediffmail.com


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.


General anesthesia; Lymphocytes; Neutrophils; Neutrophil lymphocyte ratio; Spinal anesthesia

MeSH Terms

Anesthesia, General
Anesthesia, Spinal
Leukocyte Count
Prospective Studies
Stress, Physiological
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