SHOULD SPINAL ANESTHESIA be used in surgery for herniated intervertebral disk?

Ditzler, John W.; Dumke, Paul; Harrington, Jennifer; Fox, Joan

doi:10.1213/00000539-195903000-00008

Cited by 27 publications

(16 citation statements)

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“…Just as some authority believes that general anaesthesia is the method of choice for spine procedures,[ 9] Conversely, regional anaesthesia which seem recent/novel have been used for laminectomy as far back as seven decades. [2] but the preference for general anaesthesia may either be related to the lack of familiarity with the use of RA in such procedures or may reflect the uncertainty concerning the potential risks and complications incurred when surgeries involving the spine are performed [10].…”

Section: Discussionmentioning

confidence: 99%

“…It isn't a new technique; one of the earliest reports was in 1959. [2] However, patient selection is important in choosing who will benefit maximally from the use of it.…”

Section: Discussionmentioning

confidence: 99%

“…General anesthesia has the advantage of being adaptable for carrying out prolonged surgeries in the prone position without airway compromise and some surgeons and anaesthesiologist prefer using it [1]. Anecdotal practice avoids regional anaesthesia particularly in patients with pre-existing disease of the central nervous system [2], Regional anaesthesia for laminectomy is not a common anaesthetic option because of the presence of pre-existing disease of the nervous system, awkward surgical position and the likely use of the lumbar space as point of surgical intervention may have been limiting factors. However, the superiority of general anaesthesia over regional anaesthesia for lumbar laminectomy is still controversial.…”

Section: Introductionmentioning

confidence: 99%

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Regional Anaesthesia for Lumbar Laminectomy- Case Series

Idehen¹,

Agbonkhese²,

C³

et al. 2019

IJCR

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The use of central neuraxial anaesthesia for lumbar laminectomy is evolving in our centre with its attendant advantages like decrease in intraoperative blood loss, peri-operative cardiac ischemic incidents, postoperative hypoxic episodes, arterial and venous thrombosis, and it provides longer/ adequate postoperative pain control. Nonetheless, blindness a possible complication under general anaesthesia is preventable with regional anaesthesia, this is because patient is awake and there is no restriction in neck movement. This case series helps to provide feasibility of lumbar laminectomy under central neuraxial anaesthesia (spinal, epidural and combined spinal epidural anaesthesia).

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Section: Discussionmentioning

confidence: 99%

“…It isn't a new technique; one of the earliest reports was in 1959. [2] However, patient selection is important in choosing who will benefit maximally from the use of it.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Regional Anaesthesia for Lumbar Laminectomy- Case Series

Idehen¹,

Agbonkhese²,

C³

et al. 2019

IJCR

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“…There are controversies among researchers regarding the use of SA in PNCL due to the most important issue which is acute hypotension, resulting from sympathetic block [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Spinal versus general anaesthesia in percutaneous nephrolithotomy

2017

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Background: Hemodynamic stability and blood loss reduction are subjects to further consideration in patients undergoing percutaneous nephrolithotomy (PNCL). Objectives: This study compared the preference of spinal anaesthesia (SA) or general anaesthesia (GA) in respect to mentioned concerns. Methods: In this randomized clinical trial, 59 patients who underwent PCNL divided into SA and GA groups. 15-20 mg from intra-thecal bupivacaine 0.5%, and premedication of 0.01-0.02 mg from midazolam, were given to patients in SA group (n = 29). Patients in GA group (n = 30) received premedication of 1-2 μg/kg from fentanyl and 0.01-0.02 mg/kg from midazolam, and intravenously anaesthetized with 100 μg/kg/min of propofol and 0.5 mg/kg of atracurium, given by continuous infusion and N2O/O2 50%. Mean arterial pressure (MAP) and heart rate were recorded intra-operatively and during recovery. Results: MAP and heart rate show no significant differences at designated time points between two groups (P > 0.05). Surgery time, anesthesia time, bleeding volume, and analgesic intake were significantly reduced in SA group (P < 0.05). Conclusions: Regional epidural anaesthesia is an alternative technique for PCNL which achieves more patient satisfaction, less early postoperative pain and less adverse effects from medication with the same efficacy and safety compared to general anaesthesia. It seems that, in patients undergoing PNCL, SA is as effective and safe as GA and with many advantages over it.

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“…Further, the extent of complications in PCNL surgery towards spinal anesthesia has been reported to be less (Aravantinos , 2007). Among researchers, use of spinal anesthesia in PCNL is highly controversial due to the crucial issue of acute hypotension developed following sympathetic block (Urwin , 2000;Indelli , 2005;Sakura, 2007;Ditzler , 1959). Thus, in treating hypotension resulting from spinal anesthesia, given its physiological cause, the two essential methods of increasing the resistance of systemic vessels and raising the volume of intravascular fluid are crucial (Macarthur & Riley, 2007).…”

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confidence: 99%