Regional anesthesia versus general anesthesia for surgery on the lumbar spine: A review of the modern literature

Joaquin O. De Rojas, Peter Syre, William C. Welch

Research output: Contribution to journalReview articlepeer-review

Abstract

Lumbar spine surgery can be performed using different anesthetic techniques such as general endotracheal anesthesia (GA) or spinal-based regional anesthesia (RA). Several studies have been performed comparing these two anesthetic techniques and have revealed disparate results. As such, we set out to review the relevant literature. We performed a literature search for clinical articles comparing cohorts of patients who underwent RA versus GA for lumbar spine surgeries. We compared results of these studies between groups with respect to the following outcome variables: heart rate (HR), mean arterial pressure (MAP), blood loss, duration of surgery, time spent in the PACU, post-operative analgesic use or pain scores, urinary retention rates, and nausea or anti-emetic requirements. Eleven studies were identified that compared cohorts of patients who underwent GA or RA. Of these, 4 were randomized control trials, 3 were case control trials, 2 were prospective cohorts, and 2 retrospective analyses. Seven-out-of-seven studies reported reduced HRs and MAPs in the RA compared to GA group, and 7/9 studies reported a lower incidence of post-operative analgesic requirement and/or decreased pain scores for the RA group. Our review of the literature suggests that both RA and GA are safe and effective techniques for lumbar spine surgery and that RA may prove a better alternative than GA for healthy patients undergoing simple lumbar decompression procedures or for patients who are at high risk for general anesthetic complications.

Original languageEnglish (US)
Pages (from-to)39-43
Number of pages5
JournalClinical Neurology and Neurosurgery
Volume119
DOIs
StatePublished - Apr 2014

Keywords

  • Discectomy
  • General anesthesia
  • Laminectomy
  • Lumbar
  • Spinal anesthesia

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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