This observational study compares the effects of spinal versus general anesthesia on the perioperative systemic inflammatory response in adults undergoing PCNL. Routine clinical laboratory values (NLR, RDW, LAR) obtained preoperatively and postoperatively will be recorded to evaluate between-group and within-group changes. No additional blood sampling will be performed beyond standard care.
The study will be conducted at the Department of Anesthesiology and Reanimation, Elazığ Fethi Sekin City Hospital, among adult patients scheduled for PCNL (ASA I-III). The anesthesia type (spinal vs general) is determined by clinical requirements; investigators do not influence this choice. Sampling windows: Preoperative: within ≤6 hours before surgery Postoperative: first sample obtained within 6-24 hours after surgery Parameters: NLR (neutrophil/lymphocyte), RDW, LAR; plus age, sex, ASA class, operative time, and in-hospital complications. Statistics: Normality testing; between-group comparisons by independent t-test or Mann-Whitney U; within-group by paired t-test or Wilcoxon; categorical by chi-square; p\<0.05 significant. Power considerations target ≥45 per group (total ≥90). No extra biospecimens will be collected beyond routine care.
Study Type
OBSERVATIONAL
Enrollment
90
Patients receive either spinal or general anesthesia according to routine clinical decision-making. No investigational drug or device is administered.
Elazığ Fethi Sekin City Hospital
Elâzığ, Merkez, Turkey (Türkiye)
Change in Neutrophil-to-Lymphocyte Ratio (ΔNLR)
Difference in neutrophil-to-lymphocyte ratio (NLR) between preoperative (≤6 hours before surgery) and postoperative (6-24 hours after surgery) blood samples in spinal vs general anesthesia groups.
Time frame: Baseline (≤6 hours preoperative) and 24 hours postoperatively
Change in Red Cell Distribution Width (ΔRDW)
Difference in RDW values between preoperative (≤6 hours before surgery) and postoperative (6-24 hours after surgery) blood samples in spinal vs general anesthesia groups.
Time frame: Baseline (≤6 hours preoperative) and 24 hours postoperatively
Change in Lactate-to-Albumin Ratio (ΔLAR)
Difference in LAR values between preoperative (≤6 hours before surgery) and postoperative (6-24 hours after surgery) blood samples in spinal vs general anesthesia groups.
Time frame: aseline (≤6 hours preoperative) and 24 hours postoperatively
Postoperative Complications
Occurrence of any PCNL-related complications (e.g., bleeding, infection) during index hospitalization.
Time frame: From surgery until hospital discharge (up to 7 days)
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