Eurasian Journal of Chemical, Medicinal and Petroleum Research

Abstract Introduction: Femoral fracture surgery in elderly patients is frequently followed by substantial acute postoperative pain, which may be influenced not only by surgical trauma but also by systemic inflammatory and immune responses. Because the Systemic Immune-Inflammation Index may reflect this biological susceptibility, the present study aimed to pathologically assess its association with the severity of acute postoperative pain after femoral fracture surgery.

Material and methods: This descriptive cross-sectional study was conducted at Shahid Madani Hospital, Tabriz, on 93 elderly patients selected by convenience sampling, with sample size estimated using Cochran’s formula. Demographic, clinical, laboratory, surgical, and postoperative pain data were collected. The Systemic Immune-Inflammation Index was calculated from preoperative platelet, neutrophil, and lymphocyte counts, and its association with acute postoperative pain severity was statistically evaluated.

Results: Patients with severe postoperative pain had markedly higher preoperative SII than those with moderate or mild pain (1801.2±789.6 vs 1280.5±542.7 and 850.2±386.4; P<0.001), along with higher inflammatory markers, lower hemoglobin and albumin, longer operations, greater blood loss, more opioid use, delayed mobilization, and longer hospitalization (all P<0.05). SII correlated with pain intensity (highest 24-hour NRS: r=0.574, P<0.001) and independently predicted severe pain (OR=2.86, 95% CI 1.54-5.31), with good accuracy (AUC=0.812).

Conclusion: Preoperative SII appears to be a clinically useful biomarker for identifying patients at increased risk of severe acute postoperative pain. Its independent association with pain severity and acceptable diagnostic performance suggest that SII may support early perioperative risk stratification and help guide individualized analgesic planning, particularly in patients with an elevated inflammatory burden before surgery.

Abstract Background: Postoperative pain remains a significant clinical challenge, affecting up to 80% of surgical patients and impeding recovery. Standardized pain management protocols, including Enhanced Recovery after Surgery (ERAS) pathways and opioid-sparing analgesia strategies, have developed to address this issue through systematic, multimodal approaches.

Objective: This study aims to assess the effectiveness of standardized pain management protocols in improving postoperative recovery outcomes among surgical patients.

Methods: A systematic review and meta-analysis conducted following PRISMA guidelines. PubMed, Embase, Web of Science, and Cochrane Library searched for randomized controlled trials and comparative studies evaluating standardized pain protocols versus conventional care. Primary outcomes included postoperative pain scores, opioid consumption, and length of hospital stay, opioid-related adverse effects, and patient satisfaction. 58 studies (5,614 patients) were included in the final analysis.

Results: Standardized pain protocols were associated with significantly reduced 24-hour morphine consumption (MD: -9.47 mg, 95% CI: -13.00 to -5.95), lower pain scores at 24 hours (MD: -0.72, 95% CI: -0.97 to -0.47), reduced PONV incidence (OR: 0.73, 95% CI: 0.59-0.90), and improved patient satisfaction (MD: 0.88, 95% CI: 0.36-1.40). Length of stay showed a reduction from 3.0 to 2.1 days (p

Abstract Background: The Systemic Immune-Inflammation Index (SII) has emerged as a reliable marker of systemic inflammation and has been associated with various postoperative outcomes in surgical patients. However, its relationship with acute postoperative pain in patients undergoing hip arthroplasty for femoral fractures remains underexplored. Objective: This study aims to investigate the correlation between the SII and acute pain intensity in patients undergoing hip arthroplasty for femoral fractures, along with its association with postoperative clinical outcomes such as length of hospital stay (LOHS), ICU admission, and platelet count.

Methods: This prospective observational study was conducted with 112 patients who underwent hip arthroplasty for femoral fractures. Preoperative blood samples were used to calculate the SII, and pain intensity was measured at various time points postoperatively using a visual analog scale (VAS). Clinical outcomes, including LOHS, ICU admissions, and platelet counts, were recorded.

Results: A significant positive correlation was found between the SII and postoperative pain intensity, with higher SII values associated with increased pain levels at 2 and 4 hours postoperatively (r = +0.745, p = 0.005). Additionally, patients with elevated SII values had significantly longer hospital stays (22 days vs. 17 days, p = 0.006), higher ICU admission rates (27.94% vs. 16.60%, p = 0.036), and elevated platelet counts. The SII was also significantly correlated with neutrophil and lymphocyte counts, highlighting its role in reflecting the inflammatory response.

Conclusion: The SII appears to be a promising predictor of postoperative pain intensity and adverse clinical outcomes in patients undergoing hip arthroplasty for femoral fractures. Elevated SII values are associated with increased pain, prolonged hospital stays, and higher rates of ICU admission. These findings suggest that the SII could serve as a useful biomarker for assessing postoperative complications and guiding clinical management in surgical patients.