Comparison of Combined Epidural-General Anesthesia and General Endotracheal Anesthesia on Neutrophil-Lymphocyte Ratio and Blood Sugar Levels in Colorectal Surgery

Abstract

Colorectal surgery induces systemic inflammatory and neuroendocrine stress responses that may affect postoperative outcomes. The neutrophil–lymphocyte ratio (NLR) and random blood glucose (RBG) levels are simple biomarkers for assessing perioperative inflammatory and metabolic stress. Combined epidural–general anesthesia (CEGA) is presumed to better attenuate these responses than general endotracheal anesthesia (GETA). This randomized controlled trial compared the effects of CEGA and GETA on perioperative changes in NLR and RBG in patients undergoing colorectal surgery. A total of 24 patients with American Society of Anesthesiologists (ASA) physical status I–II were randomly assigned to the CEGA (n = 12) or GETA (n = 12) group. NLR and RBG were measured preoperatively and at 6 and 24 hours postoperatively. Both groups demonstrated significant increases in NLR and RBG at 6 hours after surgery, followed by a decline at 24 hours. However, NLR at 24 hours postoperatively was significantly lower in the CEGA group than in the GETA group (p = 0.009). RBG levels were also significantly lower in the CEGA group at 6 hours (p = 0.012) and 24 hours postoperatively (p = 0.007). These findings indicate that CEGA is more effective than GETA in attenuating inflammatory and metabolic stress responses in colorectal surgery.