{"title":"中性粒细胞-淋巴细胞比例与蛛网膜下腔阻滞剖宫产术后疼痛的关系:一项前瞻性观察研究。","authors":"Roopa Sachidananda, Alisha Malipatil, Vikas Joshi, Akila Hosamani, Anusha Haranagatti, Mahesh D Kurugodiyavar","doi":"10.4103/joacp.joacp_213_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aims: </strong>Cesarean section is one of the most commonly performed surgeries in obstetrics. Various methods have been employed to assess postoperative pain. Surgical trauma causes acute phase response with neutrophilia and relative lymphopenia. Hence neutrophil lymphocyte ratio (NLR) can be taken as an objective tool to measure acute pain. The primary objective of the study was to evaluate the relationship between postoperative NLR and pain, which was assessed using visual analogue scale (VAS).</p><p><strong>Material and methods: </strong>A prospective observational study was conducted on 120 pregnant women aged between 18 to 38 years belonging to American Society of Anesthesiologists Physical Status II undergoing elective cesarean section under subarachnoid block, in a tertiary care hospital over 18 months. Postoperatively pain was assessed using VAS. Blood samples were sent and NLR was calculated preoperatively and postoperatively. Injection diclofenac and tramadol was administered for postoperative pain and total doses of respective drugs were noted. The correlation between NLR and VAS was assessed using Spearman's rank correlation analysis.</p><p><strong>Results: </strong>The postoperative NLR was higher than the preoperative NLR. There was significant correlation between VAS score and NLR score at 12<sup>th</sup>, 24<sup>th</sup> and 48<sup>th</sup> h [(Spearman's rank correlation coefficient), r = 0.462, <i>P</i> < 0.001; r = 0.519 <i>P</i> < 0.001; r = 0.455 <i>P</i> < 0.001]. The diclofenac requirement was significantly high at 24 h among the repeat cesarean section patients (<i>P</i> = 0.023).</p><p><strong>Conclusion: </strong>The postoperative NLR correlated significantly with VAS. NLR can be used as a surrogate marker for pain assessment.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 3","pages":"464-469"},"PeriodicalIF":1.1000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237189/pdf/","citationCount":"0","resultStr":"{\"title\":\"Relationship between neutrophil-lymphocyte ratio and postoperative pain in cesarean section patients done under subarachnoid block: A prospective observational study.\",\"authors\":\"Roopa Sachidananda, Alisha Malipatil, Vikas Joshi, Akila Hosamani, Anusha Haranagatti, Mahesh D Kurugodiyavar\",\"doi\":\"10.4103/joacp.joacp_213_24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>Cesarean section is one of the most commonly performed surgeries in obstetrics. Various methods have been employed to assess postoperative pain. Surgical trauma causes acute phase response with neutrophilia and relative lymphopenia. Hence neutrophil lymphocyte ratio (NLR) can be taken as an objective tool to measure acute pain. The primary objective of the study was to evaluate the relationship between postoperative NLR and pain, which was assessed using visual analogue scale (VAS).</p><p><strong>Material and methods: </strong>A prospective observational study was conducted on 120 pregnant women aged between 18 to 38 years belonging to American Society of Anesthesiologists Physical Status II undergoing elective cesarean section under subarachnoid block, in a tertiary care hospital over 18 months. Postoperatively pain was assessed using VAS. Blood samples were sent and NLR was calculated preoperatively and postoperatively. Injection diclofenac and tramadol was administered for postoperative pain and total doses of respective drugs were noted. The correlation between NLR and VAS was assessed using Spearman's rank correlation analysis.</p><p><strong>Results: </strong>The postoperative NLR was higher than the preoperative NLR. There was significant correlation between VAS score and NLR score at 12<sup>th</sup>, 24<sup>th</sup> and 48<sup>th</sup> h [(Spearman's rank correlation coefficient), r = 0.462, <i>P</i> < 0.001; r = 0.519 <i>P</i> < 0.001; r = 0.455 <i>P</i> < 0.001]. The diclofenac requirement was significantly high at 24 h among the repeat cesarean section patients (<i>P</i> = 0.023).</p><p><strong>Conclusion: </strong>The postoperative NLR correlated significantly with VAS. NLR can be used as a surrogate marker for pain assessment.</p>\",\"PeriodicalId\":14946,\"journal\":{\"name\":\"Journal of Anaesthesiology, Clinical Pharmacology\",\"volume\":\"41 3\",\"pages\":\"464-469\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237189/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Anaesthesiology, Clinical Pharmacology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/joacp.joacp_213_24\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/16 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Anaesthesiology, Clinical Pharmacology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/joacp.joacp_213_24","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/16 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
摘要
背景与目的:剖宫产是产科最常见的手术之一。评估术后疼痛的方法多种多样。外科创伤引起急性期反应伴中性粒细胞增多和相对淋巴细胞减少。因此,中性粒细胞淋巴细胞比率(NLR)可作为衡量急性疼痛的客观工具。本研究的主要目的是评估术后NLR与疼痛之间的关系,采用视觉模拟量表(VAS)进行评估。材料和方法:对120名年龄在18 ~ 38岁的孕妇进行前瞻性观察研究,该孕妇属于美国麻醉医师协会身体状况II,在三级医院行蛛网膜下腔阻滞下择期剖宫产术,时间超过18个月。术后疼痛采用VAS评估。术前、术后送血,计算NLR。术后疼痛给予双氯芬酸和曲马多注射,并记录两种药物的总剂量。采用Spearman秩相关分析评估NLR与VAS的相关性。结果:术后NLR高于术前NLR。VAS评分与NLR评分在第12、24、48 h有显著相关(Spearman等级相关系数),r = 0.462, P < 0.001;r = 0.519 P < 0.001;r = 0.455 P < 0.001]。重复剖宫产患者24 h双氯芬酸需氧量显著增高(P = 0.023)。结论:术后NLR与VAS有显著相关性。NLR可作为疼痛评估的替代指标。
Relationship between neutrophil-lymphocyte ratio and postoperative pain in cesarean section patients done under subarachnoid block: A prospective observational study.
Background and aims: Cesarean section is one of the most commonly performed surgeries in obstetrics. Various methods have been employed to assess postoperative pain. Surgical trauma causes acute phase response with neutrophilia and relative lymphopenia. Hence neutrophil lymphocyte ratio (NLR) can be taken as an objective tool to measure acute pain. The primary objective of the study was to evaluate the relationship between postoperative NLR and pain, which was assessed using visual analogue scale (VAS).
Material and methods: A prospective observational study was conducted on 120 pregnant women aged between 18 to 38 years belonging to American Society of Anesthesiologists Physical Status II undergoing elective cesarean section under subarachnoid block, in a tertiary care hospital over 18 months. Postoperatively pain was assessed using VAS. Blood samples were sent and NLR was calculated preoperatively and postoperatively. Injection diclofenac and tramadol was administered for postoperative pain and total doses of respective drugs were noted. The correlation between NLR and VAS was assessed using Spearman's rank correlation analysis.
Results: The postoperative NLR was higher than the preoperative NLR. There was significant correlation between VAS score and NLR score at 12th, 24th and 48th h [(Spearman's rank correlation coefficient), r = 0.462, P < 0.001; r = 0.519 P < 0.001; r = 0.455 P < 0.001]. The diclofenac requirement was significantly high at 24 h among the repeat cesarean section patients (P = 0.023).
Conclusion: The postoperative NLR correlated significantly with VAS. NLR can be used as a surrogate marker for pain assessment.
期刊介绍:
The JOACP publishes original peer-reviewed research and clinical work in all branches of anaesthesiology, pain, critical care and perioperative medicine including the application to basic sciences. In addition, the journal publishes review articles, special articles, brief communications/reports, case reports, and reports of new equipment, letters to editor, book reviews and obituaries. It is international in scope and comprehensive in coverage.