Abstract No.: ABS1865: Effect of general anaesthesia and subarachnoid block on neutrophil to lymphocyte ratio (NLR) in paediatric patients undergoing infra-umbilical surgeries

BACKGROUND & AIMS: Neutrophil lymphocyte ratio (NLR) is a simple marker, of inflammatory response and physiological stress. Different systems are affected by the surgical stress and the anaesthetic method. The aim of the study was to evaluate the effects of anaesthetic technique on neutrophil to lymphocyte ratio (NLR) METHODS: After obtaining the institutional ethics committee approval and parental consent, a prospective randomised double-blinded study was conducted between October 2020 to January 2021, including 42,American Society of Anesthesiologists (ASA) class I and II patients, aged 3-12 years, scheduledfor infra-umbilical surgeries. The patients were divided randomly in two groups: group G (general anaesthesia) and group S (subarachnoid block) as per the standardised protocol. Differential count of leukocytes and NLR were obtained preoperatively (T0) and post-operatively at an interval of 6 hours (T6) and 24 hours (T24). The data analysis was done using Statistical Package for the Social Sciences (SPSS) 25.0. The independent t test was used to compare the ratio. RESULTS: Baseline NLR(T0) was similar in both the groups. Mean in group G: 1.89±0.59 and in group S: 1.74±0.61, meandifference [ 95%CI] = 0.15 (-0.22-0.53), p < 0.42.Difference was statistically significant at T6. Mean in group G: 3.20±0.83 and in group S: 2.46±1.03, mean difference [95% CI] = 0.74(0.15-1.32), p < 0.014; The difference became insignificant at T24. Mean in group G: 2.88±0.70 and in group S: 2.65±0.73, mean difference [95%CI] = 0.22 (-0.22-0.68), p < 0.303. [Image: see text] CONCLUSION: The demographic parameters were comparable between the groups. NLR was significantly higher in group G than in group S, postoperatively at 6 hours. However, at 24 hours postoperatively, the difference were insignificant.