The effects of general and spinal anesthesia on systemic inflammatory response in patients undergoing total knee arthroplasty
Mehmet Eroğlu1, Serdar Kokulu2, Halit Buğra Koca3, Mehmet Ersegün Demirboğan2, Elif Doğan Baki2, Özal Özcan1
1Department of Orthopedics and Traumatology, Medical Faculty of Afyon Kocatepe University, Afyonkarahisar, Turkey
2Department of Anesthesiology and Reanimation, Medical Faculty of Afyon Kocatepe University, Afyonkarahisar, Turkey
3Department of Medical Biochemistry, Medical Faculty of Afyon Kocatepe University, Afyonkarahisar, Turkey
Keywords: General anesthesia; inflammatory response; spinal anesthesia; surgery; total knee arthroplasty.
Objectives: This study aims to compare the systemic inflammatory responses (SIRs) developing after total knee arthroplasty (TKA) performed under general or spinal anesthesia.
Patients and methods: This prospective study included 40 patients (8 males, 32 females; mean age 67.15±9.27 years; range 51 to 89 years) who underwent TKA in our clinic between February 2014 and July 2014. Patients were grouped to receive general (group 1, n=20) or spinal anesthesia (group 2, n=20). Levels of pro-inflammatory markers [Interleukin-6 (IL-6), IL-8, IL-1b, tumor necrosis factor-alpha (TNF-a) and C-reactive protein (CRP)] were studied from the venous blood samples obtained immediately before induction to anesthesia (T1), immediately after closure of the operative wound (T2), and at 24 hours postoperatively (T3).
Results: In both groups, levels of CRP and IL-6 were significantly increased at T3 compared to those achieved at T1. Changes in the levels of TNF-a in both groups were similar. There were no significant differences between the groups in terms of the changes within the levels of the studied markers at the respective time intervals.
Conclusion: According to our study results, SIRs developing after TKA performed under general or spinal anesthesia are similar.