Spinal Anestezi ile Opere Edilen Elektif Sezeryan Hastalarında Nötrofil/Lenfosit ve Trombosit/Lenfosit Oranlarının Postdural Ponksiyon Baş Ağrısı Üzerine Etkilerinin İncelenmesi

Year 2024, Volume: 21 Issue: 3, 502 - 508

Gokhan Erdem

https://doi.org/10.35440/hutfd.1518455

Abstract

Amaç: Postdural ponksiyon baş ağrısı (PDPB), lomber ponksiyon yapılan hastalarda en sık görülen komp-likasyonlardan birisidir ve hamilelikte prevalansı daha yüksektir. Nötrofil/lenfosit oranı (NLO) ve plate-let/lenfosit oranı (PLO) inflamatuar hastalıkların yanı sıra postoperatif ağrı, migren ve gerilim tipi baş ağrısı içinde prognostik önemi olan oranlar olarak değerlendirilmektedir. Bu çalışmada ise spinal anes-tezi ile gerçekleştirilen elektif sezaryen ameliyatlarında perioperatif NLO ve PLO değerlerindeki yüksek-liğin PDPB için prognostik öneminin varlığı hipotezini test etmek amaçlandı.
Materyal ve metod: Bu çalışma etik kurul onayından sonra bir eğitim ve araştırma hastanesinde 2024 Nisan – Haziran ayları arasında spinal anestezi ile opere edilen elektif sezaryen hastalarında NLO ve PLO değerlerinin PDPB üzerine etkilerinin araştırıldığı prospektif, çift kör, randomize gözlemsel vaka kontrol çalışmasıdır. Bu kapsamda preoperatif 1 gün önce ve postoperatif 2. saatte alınan kan sonucunda plate-let/lenfosit (PLO) ve nötrofil/lenfosit oranları (NLO) PDPB gelişen hasta grubu ile gelişmeyenler arasın-daki istatistiksel farklılık araştırıldı.
Bulgular: PDPB insidansı %33,3 olarak belirlendi. PDPB durumuna göre preoperatif ve postoperatif NLO değerleri açısından anlamlı farklılık tespit edildi (p<0,05). PLO değerleri açısından ise preoperatif an-lamlı farklılık tespit edildi (p<0,05). Preoperatif NLO ve PLO ile postoperatif NLO değerlerindeki yüksek-liğin, PDPB oranlarını artırmasının yanı sıra, PDPB gelişen hastalarda bu oranların yüksekliği, PDPB süresi (gün) ile 3., 4. ve 5. gün VAS değerleri açısından da anlamlı farklılıklar tespit edildi (p<0,05).
Sonuç: Spinal anestezi ile gerçekleştirilen elektif sezaryen ameliyatlarında NLO ve PLO değerleri; PDPB açısından prognostik önemi olan değerler olarak klinik pratikte kullanılabilir.

Keywords

Postdural ponksiyon baş ağrısı, Nötrofil/lenfosit oranı (NLO), Platelet/lenfosit oranı (PLO)

Ethical Statement

Çalışma Harran Üniversitesi Tıp Fakültesi Etik Kurulu izni ile gerçekleştirildi (Tarih: 01.04.2024)

Investigation of the Effects of Neutrophil/Lymphocyte and Plate-let/Lymphocyte Ratios on Postdural Puncture Headache in Elective Caesa-rean Section Patients Operated with Spinal Anesthesia

Abstract

Background: Postdural puncture headache (PDPH) is one of the most common complications in patients undergoing lumbar puncture and its prevalence is higher in pregnancy. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) are considered as prognostic ratios for inflammatory diseases as well as postoperative pain, migraine and tension-type headache. The aim of this study was to test the hypothesis that the presence of prognostic significance for PDPB in elective cesarean sections performed with spinal anesthesia is the presence of elevated perioperative NLR and PLR parameters.
Materials and Methods: This study is a prospective, double-blind, randomized observational case-control study investigating the effects of NLR and PLR values on PDPH in elective cesarean section patients who underwent spinal anesthesia between April and June 2024 in a training and research hospital after ethics committee approval. In this context, the statistical differences between the pati-ent group who developed PDPH and those who did not develop PDPH were investigated in terms of PLR and NLR as a result of blood taken 1 day before preoperatively and 2 hours after surgery.
Results: The incidence of PDPB was determined as 33.3%. A significant difference was found in terms of preoperative and postoperative NLR values according to PDPB status (p<0.05). A significant difference was found in terms of PLR values preoperatively (p<0.05). In addition to the fact that the elevation in preoperative NLR and PLR and postoperative NLR values increased the rates of PDPB, significant diffe-rences were also detected in terms of the duration of PDPB (days) and the VAS values on the 3rd, 4th and 5th days with the elevation of these rates in patients who developed PDPB (p<0.05).
Conclusions: NLR and PLR values in elective caesarean sections performed with spinal anesthesia can be used in clinical practice as values with prognostic significance for PDPH.

Ethical Statement

Çalışma için Harran Üniversitesi Klinik Araştırmalar Etik kurulun-dan 01.04.2024 tarihli HRÜ/24.03.37 sayılı etik kurul onayı alınmıştır.

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