Efficiency of Spinal Anesthesia versus General Anesthesia for Minimal Invasive Single Level Transforaminal Lumbar Interbody Fusion: A Retrospective Analysis of 178 Patients

IF 0.7
Ameya Rangnekar, Goparaju V.N.R. Praveen, A. Chugh, Saijyot Raut, Vishal G. Kundnani
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Abstract

Objective: To evaluate the efficacy of spinal anesthesia in patients undergoing minimal invasive single level transforaminal lumbar interbody fusion (MIS TLIF) surgery and to compare the re-sults with that of general anesthesia. Method: 178 patients were included in the study, 86 were in general anesthesia and 92 were in spinal anesthesia. Patients aged between 20 to 70 years who had undergone MIS TLIF not responding to 6 weeks of conservative treatment were included. The routine steps of anesthesia for both general and spinal anesthesia were adhered. The visual analogue scale, blood loss, duration of surgery, time from entering operation theatre to time of incision, time of bandaging to exit from operation theatre, time of stay in Post Anesthesia Care Unit (PACU), nausea/vomiting, urinary retention, duration of stay in hospital, peri-operative complications were compiled and assessed. Appropriate statistical analysis was applied. Results: The mean time for entering the operation theatre to the incision; mean time from ban-daging to the exit; mean PACU time and the mean hospital stay were significantly lower in the spinal anesthesia group (p<0.05). The other parameters are comparable except, urinary retention which was significantly higher in spinal anesthesia group (p<0.05). Conclusion: Spinal anesthesia offers efficient operating room functioning with decreasing overall operation theatre time. It is very efficient alternative technique to general anesthesia which can be considered for elective lumbar surgeries with a lower late of adverse events especially at lower lumbar levels.
178例微创单节段经椎间孔腰椎椎体间融合术中腰麻与全身麻醉的疗效对比
目的:评价脊髓麻醉在微创单节段经椎间孔腰椎椎体间融合术(MIS TLIF)中的应用效果,并与全麻进行比较。方法:178例患者全麻86例,脊髓麻醉92例。年龄在20 - 70岁之间,接受过MIS TLIF的患者对6周保守治疗无反应。全身麻醉和脊髓麻醉均按常规操作。编制视觉模拟量表、出血量、手术时间、进入手术室至切口时间、包扎至离开手术室时间、麻醉后护理病房(PACU)住院时间、恶心/呕吐、尿潴留、住院时间、围手术期并发症。应用了适当的统计分析。结果:进入手术室至切口的平均时间;从封条到出口的平均时间;脊髓麻醉组平均PACU时间和平均住院时间显著低于对照组(p<0.05)。除尿潴留显著高于脊髓麻醉组(p<0.05)外,其他参数均具有可比性。结论:脊髓麻醉在减少手术时间的同时,提高了手术室的效率。这是一种非常有效的替代全麻的技术,可以考虑用于选择性腰椎手术,不良事件的发生率较低,特别是在腰椎水平较低。
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