Spine surgery under neuraxial vs. general anesthesia: the current state of comparative outcomes research.
Journal
Current opinion in anaesthesiology
ISSN: 1473-6500
Titre abrégé: Curr Opin Anaesthesiol
Pays: United States
ID NLM: 8813436
Informations de publication
Date de publication:
01 Oct 2023
01 Oct 2023
Historique:
medline:
11
9
2023
pubmed:
8
8
2023
entrez:
8
8
2023
Statut:
ppublish
Résumé
The impact of primary anesthetic technique on outcomes after spine surgery is controversial. Given frequent calls for well designed prospective comparative studies of neuraxial anesthesia vs. general anesthesia and recent reports of 'awake spine surgery' successes in the surgical literature, an updated evidence review is indicated. Systematic reviews, population-based and retrospective cohort studies suggest few significant differences in important complications or global recovery between anesthetic techniques. On the basis of overall low-to-moderate quality evidence, neuraxial anesthesia is associated with statistically significant benefits for several individual outcomes compared with general anesthesia, including improved intraoperative hemodynamic stability, less postoperative nausea and vomiting, lower early pain scores and shorter length of hospital stay. There are ongoing calls for well designed, adequately powered prospective studies. Our understanding of the risks, benefits and comparative outcomes between neuraxial anesthesia and general anesthesia for spine surgery is evolving. Although the results derived from this body of literature suggest specific benefits of neuraxial anesthesia, further research is required before widespread recommendations for either technique can be made. Until then, both neuraxial anesthesia and general anesthesia are reasonable choices for lumbar spine surgery of short duration, in appropriately selected patients.
Identifiants
pubmed: 37552009
doi: 10.1097/ACO.0000000000001294
pii: 00001503-990000000-00119
doi:
Substances chimiques
Anesthetics
0
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
516-524Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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