A retrospective comparison of the effects of low-flow and high-flow anesthesia on hemodynamics,  neutrophil-to-lymphocyte ratio, and postoperative  outcomes in Tympanoplasty and Myringoplasty  surgeries

Journal of Anesthesia and Critical Care: Open access, cilt.17, sa.4, ss.119-123, 2025 (Hakemli Dergi)

Abstract

Objective:The neutrophil-to-lymphocyte ratio (NLR) is increasingly utilized as a practical

and cost-effective parameter for evaluating systemic inflammation and predicting the

prognosis of various diseases. This study aimed to compare the effects of low-flow and

high-flow anesthesia on hemodynamic parameters and NLR levels.

Methods:With ethics committee approval, this retrospective study included 50 patients

who underwent tympanoplasty or myringoplasty. Patients receiving high-flow anesthesia

(Group Y) at 3 L/min and those receiving low-flow anesthesia (Group D) at 0.75 L/min

were included. Data on age, sex, weight and hemodynamics were obtained from anesthesia

records. NLR was calculated from preoperative and postoperative complete blood count

results. Sevoflurane consumption was also determined.

Results:The groups did not differ significantly in terms of age, sex, body mass index,

anesthesia duration, and complication rates. A significant postoperative increase in NLR

was observed in Group Y, but not in Group D. Intergroup comparison revealed that

postoperative NLR was significantly lower in Group D compared to Group Y. Sevoflurane

consumption was also significantly lower in the low-flow group.

Conclusion: Low-flow anesthesia may offer environmental and economic advantages by

reducing volatile anesthetic consumption. Furthermore, it may help attenuate the systemic

inflammatory response, suggesting a potential clinical benefit in its use.

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