Effects of Low-Flow and Standard-Flow Sevoflurane Anesthesia on Inflammatory Markers in Bariatric Surgery

This retrospective observational study aimed to compare the effects of low-flow and standard-flow sevoflurane anesthesia on perioperative inflammatory responses in patients undergoing laparoscopic sleeve gastrectomy for obesity. Data were obtained from the anesthesia and laboratory records of 155 adult patients who received either low-flow (1 L/min) or standard-flow (4 L/min) sevoflurane anesthesia between January 2022 and January 2025 at Adana City Training and Research Hospital. Preoperative and postoperative inflammatory markers, including C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and red cell distribution width (RDW), were recorded and compared between the two groups. Hemodynamic parameters such as mean arterial pressure and heart rate were also analyzed to assess intraoperative stability. The primary objective of the study was to evaluate the impact of anesthetic flow rate on perioperative inflammation, while the secondary objective was to assess hemodynamic stability during anesthesia. This study may contribute to a better understanding of how low-flow anesthesia influences systemic inflammatory responses and perioperative hemodynamics in morbidly obese patients undergoing bariatric surgery.

Inclusion Criteria: * Adult patients aged 18-60 years * Underwent laparoscopic sleeve gastrectomy under general anesthesia * Received low-flow or standard-flow sevoflurane anesthesia * ASA physical status I-III * Complete perioperative records available Exclusion Criteria: * Conversion to open surgery * Incomplete or missing data * Significant comorbidities (e.g., severe cardiac, hepatic, or renal dysfunction) * Perioperative complications unrelated to anesthesia * Age \60 years