title: The effect of anesthetic techniques on neutrophil-to-lymphocyte ratio after laparoscopy-assisted vaginal hysterectomy.
abstract: BACKGROUND
  Surgical stress can induce postoperative systemic leukocytic alterations, including leukocytosis, neutrophilia, or lymphopenia. The present study investigated whether the anesthetic technique could affect the leukocytic alterations, including neutrophil-to-lymphocyte (N/L) ratio, after gynecologic laparoscopy.
  
  
  METHODS
  Forty patients scheduled for laparoscopy-assisted vaginal hysterectomy were randomly assigned into two groups: PR group, which received total intravenous anesthesia with propofol and remifentanil, and S group, which received inhalational anesthesia with sevoflurane. Differential counts of leukocytes with N/L ratio of peripheral blood were obtained just before induction (T1), at the end of surgery (T2), 2 hours after surgery (T3), and 24 hours (T4) after surgery.
  
  
  RESULTS
  Significant increase in total leukocytic count, neutrophil count, and N/L ratio, and decrease in lymphocytic count were observed at all time points after surgery in both groups. N/L ratio was significantly lower in group PR compared with group S at T3. The increase of N/L ratio in contrast to the value at T1 was significantly lower at T2 and T3 in group PR compared with that of group S.
  
  
  CONCLUSIONS
  Total intravenous anesthesia with propofol and remifentanil resulted in transient but salient leukocytic alterations in the peripheral blood in terms of N/L ratio compared with inhalational anesthesia with sevoflurane in laparoscopy-assisted vaginal hysterectomy.
authors: Department of Anesthesiology and Pain Medicine, Samsung Seoul Hospital, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-gu, Seoul, Republic of Korea.
authors: Won Ho
authors: WH
authors: Kim
authors: Hyun Seung
authors: HS
authors: Jin
authors: Justin Sangwook
authors: JS
authors: Ko
authors: Tae Soo
authors: TS
authors: Hahm
authors: Sangmin Maria
authors: SM
authors: Lee
authors: Hyun Sung
authors: HS
authors: Cho
authors: Myung Hee
authors: MH
authors: Kim
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D007108:Immune Tolerance; D010535:Laparoscopy / Q000379:methods*; D007958:Leukocyte Count; D008214:Lymphocytes / Q000187:drug effects*; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects*; D011446:Prospective Studies