Effect of combined epidural and general anesthesia on the systemic immune-inflammation index in colorectal surgery: a retrospective study

Aim The surgical stress response is influenced by the type of anesthesia and may affect the inflammatory response. The systemic immune inflammation index (SII) is a parameter that helps to better characterize the inflammatory microenvironment. In this study, we aimed to compare the short-term postoperative effects of adding epidural analgesia to general anesthesia on the SII value in patients undergoing elective colorectal surgery. Methods Patients diagnosed with colon and rectal cancer who underwent elective operation were divided into two groups. Patients who received only general anesthesia were referred to as Group 1, and patients in whom epidural anesthesia was added to general anesthesia were referred to as Group 2. Demographic data and preoperative, postoperative 4th-hour, and 24th-hour SII values, as well as the statistical relationship between them, were analyzed. Results Neither group showed a statistically significant difference. (P = .210 and P = .577, respectively). In intragroup evaluations, SII values for the general anesthesia group increased statistically significantly [675.8 (217.0-6645.3)] after treatment [2329.7 (592.1-7730.6)] compared to the pre-treatment period (P < .001. 001), and similarly in the epidural + general anesthesia group, SII values increased statistically significantly [610.8 (161.6-3951.5)] after treatment [1990.6 (643.5-8651.0)] compared to the pre-treatment period (P < .001). Conclusion We believe that both methods of anesthesia have a negative effect on the systemic inflammatory microenvironment, and that the combined method and epidural anesthesia do not reduce the negative effects of general anesthesia.