Do Hipnotic Anesthetic Agents Used in Patients Undergoing Radical Prostatectomy Have An Effect on the Neutrophil/Lymphocyte Ratio? Retrospective Study

Objective: Anesthetic agents and applications affect tumor pathophysiology and immunosuppression in the postoperative period. We evaluated the changes made by hypnotic anesthetic agents used during anesthesia on neutrophil/lymphocyte ratio (NLR) in patients undergoing radical prostate surgery and its relationship with short-term morbidity. Materials and Methods: Age of patients who had radical prostatectomy, physical classification of the American Society of Anesthesiology, perioperative blood transfusion, drugs used during general anesthesia (intravenous, opioid, volatile anesthetic), duration of anesthesia, analgesics used in postoperative pain was examined. Preoperative, postoperative day-0 and day-2 NLR results were recorded. Results: The data of 159 patients who underwent radical prostatectomy were assessed. The patients were divided into 2 groups; Group pentotalsevoflurane/desflurane (PSD) (n=101) and Group propofol-sevoflurane/desflurane (PrSD) (n=58). There was no difference in terms of preoperative and postoperative 2 day NLR value, but the highest NLR values in the postoperative day 0 was found to be in Group PrSD. Postoperative complications were higher in Group PSD. However, preoperative NLR values of these complications were higher in Group PrSD. Erythrocyte (red blood cell) replacement patients were divided into 2 groups; between 0 and 2 units (n=147) and more than >2 units (n=12), their preoperative NLR ratios were 2.54 (0.7-16.3) and 3.3 (1.8-8.8) respectively. The cut value of NLR for bleeding was set at 1.77. Conclusion: Increased NLR result is associated with immunosuppression and tumorigenesis, and is an easy and inexpensive technique. In prostate cancer, preoperative high NLR (>1.7) may have a predictive value for bleeding, blood transfusion, and postoperative respiratory distress.