Relationship between neutrophil-lymphocyte ratio and postoperative pain in cesarean section patients done under subarachnoid block: A prospective observational study
Background and Aims: Cesarean section is one of the most commonly performed surgeries in obstetrics. Various methods have been employed to assess postoperative pain. Surgical trauma causes acute phase response with neutrophilia and relative lymphopenia. Hence neutrophil lymphocyte ratio (NLR) can be...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-07-01
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| Series: | Journal of Anaesthesiology Clinical Pharmacology |
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| Online Access: | https://journals.lww.com/10.4103/joacp.joacp_213_24 |
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| author | Roopa Sachidananda Alisha Malipatil Vikas Joshi Akila Hosamani Anusha Haranagatti Mahesh D. Kurugodiyavar |
| author_facet | Roopa Sachidananda Alisha Malipatil Vikas Joshi Akila Hosamani Anusha Haranagatti Mahesh D. Kurugodiyavar |
| author_sort | Roopa Sachidananda |
| collection | DOAJ |
| description | Background and Aims:
Cesarean section is one of the most commonly performed surgeries in obstetrics. Various methods have been employed to assess postoperative pain. Surgical trauma causes acute phase response with neutrophilia and relative lymphopenia. Hence neutrophil lymphocyte ratio (NLR) can be taken as an objective tool to measure acute pain. The primary objective of the study was to evaluate the relationship between postoperative NLR and pain, which was assessed using visual analogue scale (VAS).
Material and Methods:
A prospective observational study was conducted on 120 pregnant women aged between 18 to 38 years belonging to American Society of Anesthesiologists Physical Status II undergoing elective cesarean section under subarachnoid block, in a tertiary care hospital over 18 months. Postoperatively pain was assessed using VAS. Blood samples were sent and NLR was calculated preoperatively and postoperatively. Injection diclofenac and tramadol was administered for postoperative pain and total doses of respective drugs were noted. The correlation between NLR and VAS was assessed using Spearman’s rank correlation analysis.
Results:
The postoperative NLR was higher than the preoperative NLR. There was significant correlation between VAS score and NLR score at 12th, 24th and 48th h [(Spearman’s rank correlation coefficient), r = 0.462, P < 0.001; r = 0.519 P < 0.001; r = 0.455 P < 0.001]. The diclofenac requirement was significantly high at 24 h among the repeat cesarean section patients (P = 0.023).
Conclusion:
The postoperative NLR correlated significantly with VAS. NLR can be used as a surrogate marker for pain assessment. |
| format | Article |
| id | doaj-art-eda6142ec99b4e179b791f2cfbdf320d |
| institution | Kabale University |
| issn | 0970-9185 2231-2730 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Anaesthesiology Clinical Pharmacology |
| spelling | doaj-art-eda6142ec99b4e179b791f2cfbdf320d2025-08-20T03:31:36ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852231-27302025-07-0141346446910.4103/joacp.joacp_213_24Relationship between neutrophil-lymphocyte ratio and postoperative pain in cesarean section patients done under subarachnoid block: A prospective observational studyRoopa SachidanandaAlisha MalipatilVikas JoshiAkila HosamaniAnusha HaranagattiMahesh D. KurugodiyavarBackground and Aims: Cesarean section is one of the most commonly performed surgeries in obstetrics. Various methods have been employed to assess postoperative pain. Surgical trauma causes acute phase response with neutrophilia and relative lymphopenia. Hence neutrophil lymphocyte ratio (NLR) can be taken as an objective tool to measure acute pain. The primary objective of the study was to evaluate the relationship between postoperative NLR and pain, which was assessed using visual analogue scale (VAS). Material and Methods: A prospective observational study was conducted on 120 pregnant women aged between 18 to 38 years belonging to American Society of Anesthesiologists Physical Status II undergoing elective cesarean section under subarachnoid block, in a tertiary care hospital over 18 months. Postoperatively pain was assessed using VAS. Blood samples were sent and NLR was calculated preoperatively and postoperatively. Injection diclofenac and tramadol was administered for postoperative pain and total doses of respective drugs were noted. The correlation between NLR and VAS was assessed using Spearman’s rank correlation analysis. Results: The postoperative NLR was higher than the preoperative NLR. There was significant correlation between VAS score and NLR score at 12th, 24th and 48th h [(Spearman’s rank correlation coefficient), r = 0.462, P < 0.001; r = 0.519 P < 0.001; r = 0.455 P < 0.001]. The diclofenac requirement was significantly high at 24 h among the repeat cesarean section patients (P = 0.023). Conclusion: The postoperative NLR correlated significantly with VAS. NLR can be used as a surrogate marker for pain assessment.https://journals.lww.com/10.4103/joacp.joacp_213_24cesarean sectionpainpostoperativepregnancyspinal anesthesiavisual analog scale |
| spellingShingle | Roopa Sachidananda Alisha Malipatil Vikas Joshi Akila Hosamani Anusha Haranagatti Mahesh D. Kurugodiyavar Relationship between neutrophil-lymphocyte ratio and postoperative pain in cesarean section patients done under subarachnoid block: A prospective observational study Journal of Anaesthesiology Clinical Pharmacology cesarean section pain postoperative pregnancy spinal anesthesia visual analog scale |
| title | Relationship between neutrophil-lymphocyte ratio and postoperative pain in cesarean section patients done under subarachnoid block: A prospective observational study |
| title_full | Relationship between neutrophil-lymphocyte ratio and postoperative pain in cesarean section patients done under subarachnoid block: A prospective observational study |
| title_fullStr | Relationship between neutrophil-lymphocyte ratio and postoperative pain in cesarean section patients done under subarachnoid block: A prospective observational study |
| title_full_unstemmed | Relationship between neutrophil-lymphocyte ratio and postoperative pain in cesarean section patients done under subarachnoid block: A prospective observational study |
| title_short | Relationship between neutrophil-lymphocyte ratio and postoperative pain in cesarean section patients done under subarachnoid block: A prospective observational study |
| title_sort | relationship between neutrophil lymphocyte ratio and postoperative pain in cesarean section patients done under subarachnoid block a prospective observational study |
| topic | cesarean section pain postoperative pregnancy spinal anesthesia visual analog scale |
| url | https://journals.lww.com/10.4103/joacp.joacp_213_24 |
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