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Nigerian Journal of Clinical Practice

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Effects of thoracic epidural or intravenous analgesia on the neutrophil-to-lymphocyte ratio in thoracotomy cases

M Alkan, F.D. Erkent, Ali Çelik, A Gökçe, M Arslan, Y Ünal

Abstract


Background and Purpose: Postoperative pain is a significant problem in thoracotomy patients. Our aim in this study was to investigate the relationship between postoperative pain and neutrophil‑to‑lymphocyte ratio (NLR) which is a marker of acute inflammatory response.

Materials and Methods: Thoracic epidural or intravenous analgesia was administered to thoracotomy patients who elected to undergo a planned surgery. Patients were divided into two groups according to the analgesia method applied postoperatively. Thoracic epidural analgesia was recorded as Group 1 and intravenous analgesia as Group 2. Whole blood counts were recorded from preoperative and postoperative 24th‑ and 48th‑hour routine blood samples, and NLRs were recorded as retrospective file scanning. Postoperative 24th‑ and 48th‑hour NLRs and preoperative NLR values were recorded.

Results: Demographic data of the patients included in the study were similar except for age. Preoperative NLR was significantly higher in Group 1 at 3.50 (P = 0.004) than in Group 2 at 2.51. Postoperative NLRs were similar among both groups. Postoperative NLR values at both the 24th‑ and 48th‑hour increased by 4.9 times in Group 1 and 9.23 times in Group 2 from the 24th‑hour preoperative period, when the preoperative NLRs were evaluated. The rate of increase in Group 1 was significantly lower than in Group 2 (P = 0.006).

Conclusion: Postoperative NLR alterations when compared with preoperative values were related to the analgesic regimen used.

Keywords: Neutrophil‑to‑lymphocyte ratio, thoracic epidural, thoracotomy




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