Comparison of the Immunomodulatory Effects of Sevoflurane and Propofol Anesthesia on Pentraxin-3 and Serum Amyloid A Levels in Obese Patients Undergoing Lumbar Instrumentation Surgery

What this Trial Is About

This research aims to compare the immune system effects of sevoflurane-based inhalational anesthesia and propofol-based total intravenous anesthesia in obese adults undergoing elective lumbar instrumentation surgery. Obesity is linked to ongoing low-level inflammation and changes in immune responses, which may affect surgery outcomes. The study will focus on how these two anesthesia methods influence inflammatory markers during the perioperative period in this specific patient group. Seventy patients aged 18 to 65 years with a body mass index between 30 and 34.9 kg/m² will be randomly assigned to receive either propofol-based total intravenous anesthesia or sevoflurane-based inhalational anesthesia during lumbar surgery. Anesthesia induction will be standardized with propofol, remifentanil, and rocuronium. Maintenance will use either propofol infusion (4-10 mg/kg/h) or sevoflurane inhalation (1-1.3 MAC), both combined with remifentanil infusion and monitored by BIS. Blood samples will be taken before surgery, and then at 6 and 24 hours after surgery to assess inflammatory biomarkers. Participants will undergo blood tests to measure levels of Pentraxin-3 and serum amyloid A as primary inflammatory markers, along with secondary markers including IL-6, TNF-alpha, CRP, glucose, and complete blood counts at the three timepoints. The study will monitor these markers to understand how anesthesia type affects immune response. The trial is single-masked, randomized, and conducted at one center, with the overall participation lasting from preoperative screening through the 24-hour postoperative period.

Sevoflurane vs Propofol Anesthesia in Obese Patients Undergoing Lumbar Surgery