Hs-CRP and NLR as Markers of Perioperative Stress

Anesthesia Clinical Trial

Official title:

Hs-CRP and NLR as Markers of Perioperative Stress in Maternal And Fetal Blood in Different Anesthesia Techniques

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03594695
• Other study ID #: hsCRP
• Status: Completed
• Start date: July 20, 2018
• Est. completion date: August 20, 2018

Study information

• Verified date: October 2018
• Source: Ufuk University
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The stress response to surgery is a result of tissue injury with local and systemic inflammation that contributes to the postoperative outcome. Anesthesia is known to effect perioperative stress response Regional anesthesia modifies stress response through afferent blockage whereas general anesthesia affects the stress response via central modulation. High sensitive C-reactive protein and neutrophil to lymphocyte ratio are used for evaluation of inflammation. The aim of this study was to document the value hs-CRP and NLR in perioperative stress response in two different anesthesia methods applied to term pregnant women undergoing elective ceserean section (C/S).

Description:

The stress response to surgery is a result of tissue injury with local and systemic inflammation that contributes to the postoperative outcome. Anesthesia is known to effect perioperative stress response. Regional anesthesia modifies stress response through afferent blockage whereas general anesthesia affects the stress response via central modulation. High sensitive C-reactive protein and neutrophil to lymphocyte ratio are used for evaluation of inflammation. The degree of systemic inflammation has been determined by numerous pro- and anti-inflammatory cytokines.The cytokines control the release of C -reactive protein (CRP) which is an acute phase reactant produced by the liver. CRP is a widely used marker of inflammation and tissue damage. High sensitive C -reactive protein (hs-CRP), is a more sensitive assay for detection of inflammation measured by particle-enhanced immunonephelometry . A rapid increase in hs-CRP may indicate inflammation and tissue damage . Another well-known indicator of inflammation is neutrophil-to-lymphocyte ratio (NLR). NLR correlates strongly with elevated plasma levels of circulating proinflammatory cytokineS. The aim of this study was to document the value hs-CRP and NLR in perioperative stress response in two different anesthesia methods applied to term pregnant women undergoing elective ceserean section (C/S).

Recruitment information / eligibility

• Status: Completed
• Enrollment: 70
• Est. completion date: August 20, 2018
• Est. primary completion date: August 15, 2018
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years to 42 Years

Eligibility

Inclusion Criteria:

• Healthy pregnant women without chronic diseases at term (36-41 weeks of pregnancy)

Exclusion Criteria:

• refusal to participate,

• chronic diseases (diabetes mellitus, hypertension, heart disease, renal disease, hypo/hyperthyroidism)

• any infections,

• smoking

• contraindications for central neuraxial anesthesia.

• Pregnancies complicated with rupture of membranes, placenta previa, eclampsia/preeclampsia, and abruptio placenta

• fetal anomalies,

• abnormality detected at fetal well-being tests

Related Conditions & MeSH terms

• Anesthesia
• Cesarean Delivery Affecting Newborn
• Inflammatory Response

Intervention

Diagnostic Test:
• HSCRP and NLR
hs-CRP levels and NLR values will be studied from routine blood samples.

Locations

Country	Name	City	State
Turkey	Ufuk University	Ankara	Balgat

Sponsors (1)

Lead Sponsor	Collaborator
Ufuk University

Country where clinical trial is conducted

Turkey, 

References & Publications (2)

Chen Y, Jiang S, Wu Y. Effect of 2 different anesthesia methods on stress response in neurosurgical patients with hypertension or normal: A prospective clinical trial. Medicine (Baltimore). 2016 Aug;95(35):e4769. doi: 10.1097/MD.0000000000004769. — View Citation

Farzadnia M, Ayatollahi H, Hasan-Zade M, Rahimi HR. A comparative study of vascular cell adhesion molecule-1 and high-sensitive C-reactive protein in normal and preeclamptic pregnancies. Interv Med Appl Sci. 2013 Mar;5(1):26-30. doi: 10.1556/IMAS.5.2013.1.5. Epub 2013 Mar 19. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Evaluation of the change in HSCRP levels	Measurement of high sensitive C reactive protein levels in different time points in order to evaluate the change in HSCRP levels	preoperative, postoperative 2nd and 4th hours, fetal cord blood sample (following delivery)
Primary	Evaluation of the change in NLR	Measurement of the Neutrophil to Lymphocyte Ratio in different time points in order to evaluate the change in the Neutrophil to Lymphocyte Ratios	preoperative, postoperative 2nd and 4th hours, fetal cord blood sample (following delivery)