Effects of preoperative inflammation parameters on regional anesthesia blockade times in pregnant women

Abstract

Objective: We aimed to investigate the effects of inflammatory markers measured in pregnant women before cesarean section on the duration of sensory and motor block of local anesthetics used in regional anesthesia.

Methodology: This prospective study was conducted at Giresun Obstetrics and Pediatrics Education and Research Hospital on patients who underwent cesarean section surgery between March 15, 2023, and July 15, 2023. Neutrophil, lymphocyte, platelet and monocyte counts were recorded in the preoperative hemograms of the patients. Neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR), monocyte to platelet ratio (MPV), systemic immune inflammation index (SII), systemic inflammation response index (SIRI) and pan-immune inflammation value (PIV) were calculated. The duration of sensory block, Modified Bromage scale duration for motor block (MB1-2-3) and the duration of sensory (SBD) and motor (MBD) block reversal in the postoperative period were recorded in patients who underwent spinal anesthesia.

Results: A total of 79 patients were included in the study. Statistically significant differences were found between NLR and MB2, MB3 and SBD durations, between SII and MB1 and MB2 durations, between SIRI and MB3 duration, between PIV and MB1 duration, between PLR and MB1 and MB2 durations, between PLR and MB1 and motor block durations, between MPV and MB3 (p<0.05).

Conclusion: The use of simple and accessible biomarkers can be a valuable guide in anesthesia planning. Especially in patients with high levels of inflammation, the dose, type or method of administration of local anesthetics may be revised.