Comparison of inhalation and total intravenous anesthesia on inflammatory markers in microdiscectomy: a double-blind study.

研究概要

Forty patients with symptomatic lumbar disc herniation scheduled for microdiscectomy were randomized to receive propofol-based TIVA (n=20) or sevoflurane anesthesia (n=20). The primary outcome of interest was serum IL-6 at 24 hours post-op. Secondary outcomes of interest included C-reactive protein (CRP), procalcitonin (PCT), neutrophil-to-lymphocyte ratio (NLR) levels; perioperative variables (e.g., surgery time, transfusion, discharge timing) were also recorded. Outcomes were assessed preoperatively (T1), intraoperatively at ~30 minutes after start (T2), and 24 hours postoperatively (T3). Overall, the results of the study revealed significantly lower 24-hour IL-6 with TIVA vs sevoflurane and lower postoperative CRP with TIVA, while PCT and postoperative NLR did not differ. These findings suggest propofol-based TIVA moderates postoperative inflammatory signaling better than sevoflurane in minimally invasive spine surgery.