Regional Anesthesia for Lumbar Disc Surgery

Dagher, Christine; Narchi, P.; Naccache, Nicole; Hage, Paul; Antakly, M. C.

doi:10.1097/00000542-199809010-00044

Cited by 11 publications

(21 citation statements)

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“…One publication was excluded due to unavailability of the full‐text article. A total of eight studies were deemed to qualify and were included in the final analysis (Fig. ).…”

Section: Resultsmentioning

confidence: 99%

“…Each has advantages and disadvantages and may exert distinctive effects on peri‐operative outcome . Potential advantages of spinal anaesthesia include no airway instrumentation, profound analgesia, stable haemodynamics, less surgical blood loss and thus improved operating conditions; however, reported disadvantages include intra‐operative anxiety, cough, hiccups and movement . In contrast, general anaesthesia renders the patient motionless throughout the procedure and provides a secure airway, although it may lead to haemodynamic instability and greater intra‐operative blood loss, analgesic requirements and postoperative nausea and vomiting .…”

Section: Introductionmentioning

confidence: 99%

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Impact of spinal anaesthesia vs. general anaesthesia on peri-operative outcome in lumbar spine surgery: a systematic review and meta-analysis of randomised, controlled trials

2016

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Lumbar spinal surgery is most commonly performed under general anaesthesia. However, spinal anaesthesia has also been used. We aimed to systematically review the comparative evidence. We only included randomised, controlled trials in this meta-analysis and calculated the risk ratio or standardised mean difference for haemodynamics, blood loss, surgical time, analgesic requirement, nausea and/or vomiting, and length of hospital stay. Eight studies with a total of 625 patients were included. These were considered to be at high risk of bias. Compared with general anaesthesia, the risk ratio (95% CI) with spinal anaesthesia for intra-operative hypertension was 0.31 (0.15-0.64), I = 0% (p = 0.002); for intra-operative tachycardia 0.51 (0.30-0.84), I = 0% (p = 0.009); for analgesic requirement in the postanaesthesia care unit 0.32 (0.24-0.43), I = 0% (p < 0.0001); and for nausea/vomiting within 24 h postoperatively 0.29 (0.18-0.46), I = 12% (p < 0.00001). The standardised mean difference (95% CI) for hospital stay was -1.15 (-1.98 to -0.31), I = 89% (p = 0.007). There was no evidence of a difference in intra-operative hypotension and bradycardia, blood loss, surgical time, analgesic requirement within 24 h postoperatively, and nausea/vomiting in the postanaesthesia care unit. We conclude that spinal anaesthesia appears to offer advantages over general anaesthesia for lumbar spine surgery.

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“…One publication was excluded due to unavailability of the full‐text article. A total of eight studies were deemed to qualify and were included in the final analysis (Fig. ).…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of spinal anaesthesia vs. general anaesthesia on peri-operative outcome in lumbar spine surgery: a systematic review and meta-analysis of randomised, controlled trials

2016

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“…Reports of serious complications occurring when spinal anesthesia is applied in lumbar surgery are also rare, but have still stirred concerns about the technique (3,9). General endotracheal, spinal, and epidural anesthesia has been studied with respect to lumbar spine surgery.…”

Section: Introductionmentioning

confidence: 99%

Lumbar microdiscectomy under spinal and general anesthesia: a comparative study

Dağıstan¹,

Ökmen²,

Dağıstan³

et al. 2014

Turkish Neurosurgery

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AIm:To compare the safety and efficacy of spinal anesthesia (SA) in patients undergoing lumbar microdiscectomy (LM). mAterIAl and methOds:We evaluated 180 patients who underwent LM between 1 January 2012 and 5 July 2013. Demographic, clinical, laboratory, and pre-, intra-, and postoperative information was determined from the patients' medical records. results:Total anesthetic times were longer in the general anesthesia (GA) group. There was less bleeding at the surgical site in the SA group. Intraoperative blood pressure was significantly also lower in the SA group. Meanwhile, tachycardia was significantly higher in the GA group. The analgesic requirement in post-anesthesia care unit (PACU) was higher in the general anesthesia group. At PACU admission, analgesic requirement, heart rate, and the mean arterial pressure were higher in the GA group. Postoperative nausea and vomiting was more frequent among patients recovering in general anesthesia group. SA patients had an increased incidence of urinary retention compared with GA patients. Pulmonary complications requiring specific treatment were insignificantly higher among GA patients. COnClusIOn:In patients who undergo lumbar disc surgery, SA is a good alternative for experienced surgeons because of a more comfortable healing process.

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“…Reduction of anaesthetic time required for SA occurs as a result of eliminating the wake-up time that is necessary after GA; it is also unnecessary to monitor the patient during the post-operative period. 2,5,8,10 Reduction of surgical time seems largely related to easier positioning of the patient and to a reduction of intra-operative bleeding. The latter point is the result of multiple determinants.…”

Section: Discussionmentioning

confidence: 99%