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

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 24^th‑ and 48^th‑hour routine blood samples, and NLRs were recorded as retrospective file scanning. Postoperative 24^th‑ and 48^th‑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 24^th‑ and 48^th‑hour increased by 4.9 times in Group 1 and 9.23 times in Group 2 from the 24^th‑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