Anaesthetic techniques can modulate the intraoperative

and postoperative immune and inflammatory responses.

General anaesthesia GA often results in a greater stress

response compared to neuraxial techniques like Sub

Arachnoid Block SAB which may attenuate these effects

by blocking nociceptive input and sympathetic outflow.

General Anaesthesia suppresses cell-mediated

immunity, affects neutrophil and monocyte activity and

can exacerbate systemic inflammation. Sub Arachnoid

Block through sympathetic blockade, reduces

endocrine-metabolic stress response and improves

immune preservation. Elevated NLR Neutrophil lymphocyte ratio and MLR Monocyte Lymphocyte Ratio are

associated with increased systemic inflammation and

worse surgical outcomes. Both markers are independent

predictors of complications, length of stay, and prognosis

after surgery. Recent studies support that neuraxial

anaesthesia SAB may offer immunological advantages.

However, the comparative impact of these techniques on

NLR and MLR remains under investigated, particularly in

the context of infraumbilical surgeries ,thus necessitating

this study.

This study aims to fill this gap by evaluating the

perioperative at the end of the surgery and postoperative

changes in NLR and MLR  inflammatory response

associated with General Anaesthesia and Sub Arachnoid

Block techniques ,contributing to the understanding of immune modulation by anesthetic techniques, aiding in

evidence-based anesthesia planning.