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Peer-reviewedCC BY 4.0Metabolites

Association of Preoperative Plateletcrit and Other Inflammatory Indices with Postoperative Pain Severity and Opioid Consumption in Morbidly Obese Patients Receiving Transversus Abdominis Plane Block: A Retrospective Observational Study

4 affiliations
  1. 1Department of Anesthesiology and Reanimation, Faculty of Medicine, Malatya Turgut Özal University, 44280 Malatya, Türkiye
  2. 2Department of Anesthesiology and Reanimation, Elazığ Fethi Sekin City Hospital, 23280 Elazığ, Türkiye
  3. 3Department of Anesthesiology and Reanimation, Malatya Training and Research Hospital, 44000 Malatya, Türkiye
  4. 4Department of Anaesthesiology and Reanimation, Ankara Bilkent City Hospital, 06800 Ankara, Türkiye

Abstract

Background: Bariatric surgery induces a systemic inflammatory response to surgical stress that may influence postoperative pain and analgesic requirements, and CBC-derived inflammatory indices can reflect preoperative and postoperative immunometabolic dynamics related to this response. This retrospective observational search evaluated whether inflammatory indices derived from routine complete blood counts are associated with postoperative pain and opioid consumption after ultrasound-guided transversus abdominis plane (TAP) block in patients with morbid obesity. Methods: In this retrospective observational search, 120 patients undergoing bariatric surgery were divided into two groups: TAP block (Group T, n = 59) and local infiltration of the trocar insertion site (Group K, n = 61). Preoperative and postoperative 24-h hematological indices, VAS pain scores (0, 2, 6, 12, 24 h), and cumulative 24-h opioid consumption were analyzed. Results: Group T had significantly lower 24-h opioid consumption and VAS scores at all time points. Regarding changes between groups, the increase in neutrophil counts was greater in Group T than in Group K, whereas the change in SIRI values was smaller in Group T compared to Group K. ROC analysis showed no clinical benefit for NLR, PLR, SII, or SIRI. Only PCT (Plateletcrit) showed weak inverse discriminative ability. Conclusions: Compared with trocar site local anesthetic infiltration using an equivalent bupivacaine dose, TAP block was associated with lower postoperative pain and opioid consumption. The smaller postoperative rise in SIRI observed in the TAP block group is an exploratory, hypothesis-generating finding that did not survive correction for multiple comparisons and should not be interpreted as evidence of a causal anti-inflammatory effect. Overall, CBC-derived inflammatory indices did not perform as reliable predictive biomarkers for postoperative analgesic outcomes in this bariatric surgery population.

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BibTeX
@article{oterkus2026association,
  title = {{Association of Preoperative Plateletcrit and Other Inflammatory Indices with Postoperative Pain Severity and Opioid Consumption in Morbidly Obese Patients Receiving Transversus Abdominis Plane Block: A Retrospective Observational Study}},
  author = {Mesut Oterkus and Ümit Karatepe and Hacı Osman Toplu and Cihan Doger},
  journal = {Metabolites},
  year = {2026},
  month = oct,
  doi = {10.3390/metabo16100747},
  url = {https://www.mdpi.com/2218-1989/16/10/747},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Association of Preoperative Plateletcrit and Other Inflammatory Indices with Postoperative Pain Severity and Opioid Consumption in Morbidly Obese Patients Receiving Transversus Abdominis Plane Block: A Retrospective Observational Study
AU  - Mesut Oterkus
AU  - Ümit Karatepe
AU  - Hacı Osman Toplu
AU  - Cihan Doger
PY  - 2026
DA  - 2026/10/01
JO  - Metabolites
DO  - 10.3390/metabo16100747
UR  - https://www.mdpi.com/2218-1989/16/10/747
AB  - Background: Bariatric surgery induces a systemic inflammatory response to surgical stress that may influence postoperative pain and analgesic requirements, and CBC-derived inflammatory indices can reflect preoperative and postoperative immunometabolic dynamics related to this response. This retrospective observational search evaluated whether inflammatory indices derived from routine complete blood counts are associated with postoperative pain and opioid consumption after ultrasound-guided transversus abdominis plane (TAP) block in patients with morbid obesity. Methods: In this retrospective observational search, 120 patients undergoing bariatric surgery were divided into two groups: TAP block (Group T, n = 59) and local infiltration of the trocar insertion site (Group K, n = 61). Preoperative and postoperative 24-h hematological indices, VAS pain scores (0, 2, 6, 12, 24 h), and cumulative 24-h opioid consumption were analyzed. Results: Group T had significantly lower 24-h opioid consumption and VAS scores at all time points. Regarding changes between groups, the increase in neutrophil counts was greater in Group T than in Group K, whereas the change in SIRI values was smaller in Group T compared to Group K. ROC analysis showed no clinical benefit for NLR, PLR, SII, or SIRI. Only PCT (Plateletcrit) showed weak inverse discriminative ability. Conclusions: Compared with trocar site local anesthetic infiltration using an equivalent bupivacaine dose, TAP block was associated with lower postoperative pain and opioid consumption. The smaller postoperative rise in SIRI observed in the TAP block group is an exploratory, hypothesis-generating finding that did not survive correction for multiple comparisons and should not be interpreted as evidence of a causal anti-inflammatory effect. Overall, CBC-derived inflammatory indices did not perform as reliable predictive biomarkers for postoperative analgesic outcomes in this bariatric surgery population.
SN  - 2218-1989
ER  -