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Comparison of General and Spinal Anaesthesia on Systemic Inflammatory Response in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis

Background and Objectives: Some of the postoperative complications following orthopaedic surgeries are associated with a systemic inflammatory response (SIR), which varies depending on the anaesthetic technique. We aimed to compare the effects of general and spinal anaesthesia on the SIR after total...

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Autores principales: Kim, Ha-Jung, Roychoudhury, Priodarshi, Lohia, Stuti, Kim, Jin-Sun, Kim, Hyung-Tae, Ro, Young-Jin, Koh, Won-Uk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8623492/
https://www.ncbi.nlm.nih.gov/pubmed/34833468
http://dx.doi.org/10.3390/medicina57111250
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author Kim, Ha-Jung
Roychoudhury, Priodarshi
Lohia, Stuti
Kim, Jin-Sun
Kim, Hyung-Tae
Ro, Young-Jin
Koh, Won-Uk
author_facet Kim, Ha-Jung
Roychoudhury, Priodarshi
Lohia, Stuti
Kim, Jin-Sun
Kim, Hyung-Tae
Ro, Young-Jin
Koh, Won-Uk
author_sort Kim, Ha-Jung
collection PubMed
description Background and Objectives: Some of the postoperative complications following orthopaedic surgeries are associated with a systemic inflammatory response (SIR), which varies depending on the anaesthetic technique. We aimed to compare the effects of general and spinal anaesthesia on the SIR after total knee arthroplasty (TKA), based on C-reactive protein (CRP) levels, the platelet-lymphocyte ratio (PLR), and the neutrophil-lymphocyte ratio (NLR). Materials and Methods: Patients who underwent TKA between January 2014 and December 2018 were included. Electronic medical records of the patients were retrospectively reviewed and analysed. To reduce the impact of potential confounding factors, we performed propensity score matching according to the anaesthetic technique. Results: A total of 1311 TKA cases were analysed. After propensity score matching, the maximal CRP value and changes in CRP levels in the general anaesthesia group were higher than those in the spinal anaesthesia group. However, the maximal NLR and PLR and the changes in NLR and PLR were not different between the two groups. There were no differences in postoperative clinical outcomes. Conclusion: Spinal anaesthesia tended to induce a lower inflammatory response than general anaesthesia when considering CRP levels in patients undergoing TKA. However, the effects of anaesthetic techniques on the overall outcomes were not significant.
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spelling pubmed-86234922021-11-27 Comparison of General and Spinal Anaesthesia on Systemic Inflammatory Response in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis Kim, Ha-Jung Roychoudhury, Priodarshi Lohia, Stuti Kim, Jin-Sun Kim, Hyung-Tae Ro, Young-Jin Koh, Won-Uk Medicina (Kaunas) Article Background and Objectives: Some of the postoperative complications following orthopaedic surgeries are associated with a systemic inflammatory response (SIR), which varies depending on the anaesthetic technique. We aimed to compare the effects of general and spinal anaesthesia on the SIR after total knee arthroplasty (TKA), based on C-reactive protein (CRP) levels, the platelet-lymphocyte ratio (PLR), and the neutrophil-lymphocyte ratio (NLR). Materials and Methods: Patients who underwent TKA between January 2014 and December 2018 were included. Electronic medical records of the patients were retrospectively reviewed and analysed. To reduce the impact of potential confounding factors, we performed propensity score matching according to the anaesthetic technique. Results: A total of 1311 TKA cases were analysed. After propensity score matching, the maximal CRP value and changes in CRP levels in the general anaesthesia group were higher than those in the spinal anaesthesia group. However, the maximal NLR and PLR and the changes in NLR and PLR were not different between the two groups. There were no differences in postoperative clinical outcomes. Conclusion: Spinal anaesthesia tended to induce a lower inflammatory response than general anaesthesia when considering CRP levels in patients undergoing TKA. However, the effects of anaesthetic techniques on the overall outcomes were not significant. MDPI 2021-11-15 /pmc/articles/PMC8623492/ /pubmed/34833468 http://dx.doi.org/10.3390/medicina57111250 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Ha-Jung
Roychoudhury, Priodarshi
Lohia, Stuti
Kim, Jin-Sun
Kim, Hyung-Tae
Ro, Young-Jin
Koh, Won-Uk
Comparison of General and Spinal Anaesthesia on Systemic Inflammatory Response in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis
title Comparison of General and Spinal Anaesthesia on Systemic Inflammatory Response in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis
title_full Comparison of General and Spinal Anaesthesia on Systemic Inflammatory Response in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis
title_fullStr Comparison of General and Spinal Anaesthesia on Systemic Inflammatory Response in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis
title_full_unstemmed Comparison of General and Spinal Anaesthesia on Systemic Inflammatory Response in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis
title_short Comparison of General and Spinal Anaesthesia on Systemic Inflammatory Response in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis
title_sort comparison of general and spinal anaesthesia on systemic inflammatory response in patients undergoing total knee arthroplasty: a propensity score matching analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8623492/
https://www.ncbi.nlm.nih.gov/pubmed/34833468
http://dx.doi.org/10.3390/medicina57111250
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