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Indian Journal of Anesthesia and Analgesia

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A Comparison of General and Spinal Anaestheia for Elective Lower Lumbar Spine Surgeries in Lateral Position

Jyoti Petkar, Assistant Professor, Dept. of Anesthesiology, Pacific Medical College and Hospital, Udaipur, Rajasthan 313001, India , Jyoti Petkar1 , Prakash Audichya2 , Komal Soni3 , Sameer Goyal4 , Kiran Petkar5

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Indian Journal of Anesthesia and Analgesia 5(3):p 382-389, March 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5318.5

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Abstract

Introduction: General anesthesia (GA) is the common mode of anesthesia for spine surgery. However, with spine surgeries being increasingly performed in lateral, as against prone position, spinal anaesthesia (SA) is becoming more acceptable. This study was conducted to compare general and spinal anaesthesia in lumbar spine surgeries performed in lateral position. Materials and Methods: Patients with ASA I-II, planned to undergo single level lumbar laminectomy in lateral position were randomized into GA and SA group by computer generated random numbers. The former were given GA with endotracheal intubation as per standard protocols and latter were given SA with 3.2mL 0.5% hyperbaric bupivacaine. Surgery was performed in lateral position. Intra-operative hemodynamic events, post-operative sedation score, pain status, surgeon satisfaction, total time and complications were recorded and analysed. Results: 79 patients were studied. Mean heart rate and blood pressure were lower in SA group at various stages during surgery. Total time in operation room was 119 minutes in GA while only 94 minutes in SA group. VAS score was higher in GA group at 2 and 12 hrs post-operatively (5.2 v/s 2.4 and 4.0 v/s 2.7 respectively). Total consumption of tramadol in 24 hrs was higher in GA as compared to SA group, (mean ampoules, 3.12 v/s 2.19). Sedation score (mean grade, 1.18 v/s 0.06) and blood loss > 400 mL were higher and surgeon satisfaction lower in GA group. Conclusion: Spinal anaesthesia is a better alternative to general anaesthesia for lower lumbar spine surgeries when operated in lateral position.

 

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5318.5

Keywords

Spinal Anaesthesia; Spine Surgery in Lateral Position. 

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