The effects of general and spinal anesthesia on systemic inflammatory response in patients undergoing total knee arthroplasty.

ABSTRACT

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-1ß, tumor necrosis factor-alpha (TNF-α) 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-α 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.