In total knee arthroplasty, surgical and anesthetic procedures can lead to a significant increase in systemic inflammation. This procedure is frequently performed under either general or spinal anesthesia. However, studies investigating the effect of anesthesia type on systemic inflammation have shown conflicting results. The Systemic Inflammatory Response Index (SIRI) and the Systemic Immune-Inflammation Index (SII) provide important information about the extent of systemic inflammation. This study aimed to investigate the effects of general and spinal anesthesia on perioperative changes in SII and SIRI during total knee arthroplasty. Between January 2020 and April 2025, data from 849 patients who underwent total knee arthroplasty were retrospectively reviewed. Patients received either spinal anesthesia (Group S) or general anesthesia (Group G). The groups were compared in terms of changes in perioperative SII and SIRI (ΔSII and ΔSIRI), total opioid consumption, postoperative complications, and length of hospital stay.

Inclusion Criteria:

• Patients aged 18 to 75 years
• Patients with ASA physical status I or II
• Patients who have underwent total knee arthroplasty under general or spinal anesthesia

Exclusion Criteria:

• Patients with BMI ≥40 kg/m2
• Patients with ASA physical status ≥III
• Patients with severe cardiopulmonary or metabolic disorders, coagulation disorders or active infection
• Patients with known allergies or chronic steroid use
• Patients with incomplete laboratory data
• Patients who underwent revision total knee arthroplasty
• Patients who required intraoperative conversion from spinal to general anesthesia
• Patients with a history of major trauma and/or emergency surgery

Between January 2020 and April 2025, data from 849 patients who underwent total knee arthroplasty were retrospectively reviewed.

The data used to support the findings of this study can be obtained from the corresponding author on request.