Comparison of the Effects of Low-flow and Normal-flow Desflurane Anaesthesia on Inflammatory Parameters in Patients Undergoing Laparoscopic Cholecystectomy

Objective: According to previous studies, anaesthesia type has an important effect on immune response. However, there are limited data determining the effect of low-flow and normal-flow desflurane anaesthesia on inflammatory parameters. This study aimed to investigate the effect of low-flow and normal-flow desflurane anaesthesia on inflammatory parameters in patients undergoing laparoscopic cholecystectomy. Methods: A total of 92 patients who underwent laparoscopic cholecystectomy were retrospectively included in this study. The patients were divided into the following 2 groups according to the type of anaesthesia they received: low-flow desflurane anaesthesia group (fresh gas flow rate: 0.5 L min(-1)) and normal-flow desflurane anaesthesia group (fresh gas flow rate: 2 L min(-1)). Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were obtained before the procedure and 6 hours after the end of the procedure for all patients. Results: Although pre-procedural NLR and PLR were similar between the normal-flow and low-flow anaesthesia groups, post-procedural NLR (4.38 +/- 2.00 vs. 3.51 +/- 1.37, p=0.023) and PLR (144.38 +/- 71.04 vs. 120.58 +/- 35.35, p=0.037) were significantly higher in the normal-flow anaesthesia group. In addition, compared with pre-procedural values, post-procedural NLR (from 2.31 +/- 1.02 to 4.38 +/- 2.00, p<0.001) and PLR (from 125.60 +/- 50.97 to 144.38 +/- 71.04, p=0.017) were significantly increased in the normal-flow anaesthesia group, whereas post-procedural NLR (from 2.88 +/- 2.51 to 3.51 +/- 1.37, p=0.135) and PLR (from 121.86 +/- 42.78 to 120.58 +/- 35.35, p=0.847) did not change significantly in the low-flow anaesthesia group. Conclusion: The study results indicated that postoperative inflammatory response was significantly lower with low-flow desflurane anaesthesia than with normal-flow desflurane anaesthesia.