Regional versus general anaesthesia and neutrophil extracellular traps in orthopaedic trauma surgery: A randomised controlled trial
Babita Gupta, Pallavi Tiwari, Arulselvi Subramanian, Kamran Farooque, Mani Kalaivani, Vimi RewariABSTRACT
Background and Aims:
Anaesthetic drugs may modulate immunological responses and neutrophil functions. Neutrophil extracellular traps (NETs) are web-like chromatin structures released by activated neutrophils, comprising cell-free deoxyribonucleic acid (cfDNA), histones, and myeloperoxidase (MPO), and contribute to perioperative inflammation.
Methods:
Seventy patients aged 18–60 years, American Society of Anesthesiologists physical status I–II, undergoing isolated pelvic-acetabular or femoral shaft fracture surgery were randomised to general anaesthesia (GA,
Results:
NET formation, measured as MPO-cfDNA co-localisation events, was significantly lower in the RA group at T3 and T4 compared with GA [median (interquartile range): 1.72 (1.12–4.1) vs 3.75 (2.8–7.1),
Conclusion:
NET formation was significantly lower in the RA group at T3 and T4. A statistically significant correlation was observed between NETs and their key components (MPO and histone H3). A lower incidence of SIRS was observed in the RA group.