Spinal anesthesia efficiency in thoracolumbar stabilizations.

A spinalis anesztézia hatékonysága thoracolumbalis stabilizációban.

Journal

Ideggyogyaszati szemle
ISSN: 0019-1442
Titre abrégé: Ideggyogy Sz
Pays: Hungary
ID NLM: 17510500R

Informations de publication

Date de publication:
30 Nov 2023
Historique:
medline: 7 12 2023
pubmed: 6 12 2023
entrez: 5 12 2023
Statut: ppublish

Résumé

<p>Spinal surgery has an important place in neurosurgery practice. Surgical procedures on the lumbar spine include stabilization, discectomy, foraminotomy and decompression. Lumbar and lower thoracic spinal surgery can be safely performed under spinal anesthesia (SA). However, there are not many studies on the safety and efficacy of spinal anesthesia in patients who have undergone long segment stabilization surgery.<br><br></p>. <p>Patients who underwent lumbar and lower thoracic spinal instrumentation operations with general anesthesia (GA) or spinal anesthesia were included in the study. Demographic characteristics and American Society of Anesthesiologists (ASA) physical status of the patients were all recorded. Visual analog scale and quality of life scores were obtained before and after the operation.</p>. <p>572 patients with SA and 598 patients with GA were included in the study, 352 / 347 had only-lumbar region and 220 / 251 had thoracolumbar region operations, respectively. All patients underwent short/long segment stabilization. Mean operating time was 106.1 / 156.7 minutes. Average blood loss was 375 / 390 mL. All patients were mobilized 16-24 / 24-36 hours after surgery. In our patient group, there were both high-risk and normal-risk subgroups in terms of ASA physical status. During the clinical follow-up, a statistically significant improvement was found for VAS and quality of life scores for both groups (p&lt;0.05).</p>. <p>Spinal anesthesia appears to be a very effective method in lumbar and thoracolumbar surgery. Along with careful patient selection, using this highly effective method provides a comfortable space for the surgeon.</p>. <p>A gerincseb&eacute;szet fontos&nbsp;he&shy;lyet foglal el az idegseb&eacute;szeti gyakorlatban. Az &aacute;gy&eacute;ki gerinc seb&eacute;szeti elj&aacute;r&aacute;sai k&ouml;&shy;z&eacute; tar&shy;tozik a stabiliz&aacute;ci&oacute;, a discectomia, a fo&shy;ra&shy;mi&shy;notomia &eacute;s a dekompresszi&oacute;. Az &aacute;gy&eacute;ki &eacute;s als&oacute; mellkasi gerincműt&eacute;tek biztons&aacute;gosan v&eacute;gezhetők spinalis aneszt&eacute;zi&aacute;ban (SA). A ge&shy;rincvelői &eacute;rz&eacute;stelenít&eacute;s biztons&aacute;goss&aacute;&shy;g&aacute;&shy;r&oacute;l &eacute;s hat&eacute;konys&aacute;g&aacute;r&oacute;l azonban nem sok tanulm&aacute;ny &aacute;ll rendelkez&eacute;sre a hossz&uacute;szeg&shy;mentum-stabiliz&aacute;ci&oacute;s műt&eacute;ten &aacute;tesett betegek eset&eacute;ben.</p>. <p>A vizsg&aacute;latba olyan betegeket vontunk be, akik lumbalis vagy als&oacute; mellkasi gerincműt&eacute;ten estek &aacute;t &aacute;ltal&aacute;nos &eacute;rz&eacute;ste&shy;lenít&eacute;sben (GA) vagy spinalis &eacute;rz&eacute;stelenít&eacute;sben. A betegek demogr&aacute;fiai jellemzőit &eacute;s az Amerikai Aneszteziol&oacute;gust&aacute;rsas&aacute;g (American Society of Anesthesiologists, ASA) &aacute;ltal előírt fizikai st&aacute;tuszt r&ouml;gzített&uuml;k. A műt&eacute;t előtt &eacute;s ut&aacute;n vizu&aacute;lis anal&oacute;g sk&aacute;l&aacute;n f&aacute;jdalompontsz&aacute;mokat &eacute;s &eacute;letminős&eacute;gi pontsz&aacute;mokat m&eacute;rt&uuml;nk.</p>. <p>A vizsg&aacute;latba 572 SA-s &eacute;s 598 GA-s beteget vontunk be, 352 / 347 eset&shy;ben csak a lumbalis r&eacute;gi&oacute;ban, illetve 220 / 251 esetben a thoracolumbalis r&eacute;gi&oacute;ban v&eacute;&shy;gezt&uuml;nk műt&eacute;tet. Minden betegn&eacute;l r&ouml;vid/hossz&uacute; szegmensstabiliz&aacute;ci&oacute;t v&eacute;gezt&uuml;nk. Az &aacute;tlagos műt&eacute;ti idő 106,1 / 156,7 perc volt.&nbsp;<br>Az &aacute;tlagos v&eacute;rvesztes&eacute;g 375 / 390 ml volt. Minden beteget 16&ndash;24 / 24&ndash;36 &oacute;r&aacute;val a műt&eacute;t ut&aacute;n mobiliz&aacute;ltunk. Betegcsoportunkban az ASA fizikai st&aacute;tusz szempontj&aacute;b&oacute;l magas &eacute;s norm&aacute;lkock&aacute;zat&uacute; alcsoport egyar&aacute;nt volt. A klinikai ut&aacute;nk&ouml;vet&eacute;s sor&aacute;n mindk&eacute;t csoportban statisztikailag szignifik&aacute;ns javul&aacute;st tapasztaltunk a VAS- &eacute;s &eacute;letminős&eacute;g-pontsz&aacute;mok tekintet&eacute;ben (p &lt; 0,05).</p>. <p>A spinalis &eacute;rz&eacute;stelenít&eacute;s nagyon hat&eacute;kony m&oacute;dszernek tűnik az &aacute;gy&eacute;ki &eacute;s thoracolumbalis gerincműt&eacute;tekn&eacute;l. Gondos betegkiv&aacute;laszt&aacute;s mellett ennek a rendkív&uuml;l hat&eacute;kony m&oacute;dszernek az alkalma&shy;z&aacute;sa k&eacute;nyelmes teret biztosít a seb&eacute;sz sz&aacute;m&aacute;ra.</p>.

Sections du résumé

Background and purpose UNASSIGNED
<p>Spinal surgery has an important place in neurosurgery practice. Surgical procedures on the lumbar spine include stabilization, discectomy, foraminotomy and decompression. Lumbar and lower thoracic spinal surgery can be safely performed under spinal anesthesia (SA). However, there are not many studies on the safety and efficacy of spinal anesthesia in patients who have undergone long segment stabilization surgery.<br><br></p>.
Methods UNASSIGNED
<p>Patients who underwent lumbar and lower thoracic spinal instrumentation operations with general anesthesia (GA) or spinal anesthesia were included in the study. Demographic characteristics and American Society of Anesthesiologists (ASA) physical status of the patients were all recorded. Visual analog scale and quality of life scores were obtained before and after the operation.</p>.
Results UNASSIGNED
<p>572 patients with SA and 598 patients with GA were included in the study, 352 / 347 had only-lumbar region and 220 / 251 had thoracolumbar region operations, respectively. All patients underwent short/long segment stabilization. Mean operating time was 106.1 / 156.7 minutes. Average blood loss was 375 / 390 mL. All patients were mobilized 16-24 / 24-36 hours after surgery. In our patient group, there were both high-risk and normal-risk subgroups in terms of ASA physical status. During the clinical follow-up, a statistically significant improvement was found for VAS and quality of life scores for both groups (p&lt;0.05).</p>.
Conclusion UNASSIGNED
<p>Spinal anesthesia appears to be a very effective method in lumbar and thoracolumbar surgery. Along with careful patient selection, using this highly effective method provides a comfortable space for the surgeon.</p>.
Background and purpose UNASSIGNED
<p>A gerincseb&eacute;szet fontos&nbsp;he&shy;lyet foglal el az idegseb&eacute;szeti gyakorlatban. Az &aacute;gy&eacute;ki gerinc seb&eacute;szeti elj&aacute;r&aacute;sai k&ouml;&shy;z&eacute; tar&shy;tozik a stabiliz&aacute;ci&oacute;, a discectomia, a fo&shy;ra&shy;mi&shy;notomia &eacute;s a dekompresszi&oacute;. Az &aacute;gy&eacute;ki &eacute;s als&oacute; mellkasi gerincműt&eacute;tek biztons&aacute;gosan v&eacute;gezhetők spinalis aneszt&eacute;zi&aacute;ban (SA). A ge&shy;rincvelői &eacute;rz&eacute;stelenít&eacute;s biztons&aacute;goss&aacute;&shy;g&aacute;&shy;r&oacute;l &eacute;s hat&eacute;konys&aacute;g&aacute;r&oacute;l azonban nem sok tanulm&aacute;ny &aacute;ll rendelkez&eacute;sre a hossz&uacute;szeg&shy;mentum-stabiliz&aacute;ci&oacute;s műt&eacute;ten &aacute;tesett betegek eset&eacute;ben.</p>.
Methods UNASSIGNED
<p>A vizsg&aacute;latba olyan betegeket vontunk be, akik lumbalis vagy als&oacute; mellkasi gerincműt&eacute;ten estek &aacute;t &aacute;ltal&aacute;nos &eacute;rz&eacute;ste&shy;lenít&eacute;sben (GA) vagy spinalis &eacute;rz&eacute;stelenít&eacute;sben. A betegek demogr&aacute;fiai jellemzőit &eacute;s az Amerikai Aneszteziol&oacute;gust&aacute;rsas&aacute;g (American Society of Anesthesiologists, ASA) &aacute;ltal előírt fizikai st&aacute;tuszt r&ouml;gzített&uuml;k. A műt&eacute;t előtt &eacute;s ut&aacute;n vizu&aacute;lis anal&oacute;g sk&aacute;l&aacute;n f&aacute;jdalompontsz&aacute;mokat &eacute;s &eacute;letminős&eacute;gi pontsz&aacute;mokat m&eacute;rt&uuml;nk.</p>.
Results UNASSIGNED
<p>A vizsg&aacute;latba 572 SA-s &eacute;s 598 GA-s beteget vontunk be, 352 / 347 eset&shy;ben csak a lumbalis r&eacute;gi&oacute;ban, illetve 220 / 251 esetben a thoracolumbalis r&eacute;gi&oacute;ban v&eacute;&shy;gezt&uuml;nk műt&eacute;tet. Minden betegn&eacute;l r&ouml;vid/hossz&uacute; szegmensstabiliz&aacute;ci&oacute;t v&eacute;gezt&uuml;nk. Az &aacute;tlagos műt&eacute;ti idő 106,1 / 156,7 perc volt.&nbsp;<br>Az &aacute;tlagos v&eacute;rvesztes&eacute;g 375 / 390 ml volt. Minden beteget 16&ndash;24 / 24&ndash;36 &oacute;r&aacute;val a műt&eacute;t ut&aacute;n mobiliz&aacute;ltunk. Betegcsoportunkban az ASA fizikai st&aacute;tusz szempontj&aacute;b&oacute;l magas &eacute;s norm&aacute;lkock&aacute;zat&uacute; alcsoport egyar&aacute;nt volt. A klinikai ut&aacute;nk&ouml;vet&eacute;s sor&aacute;n mindk&eacute;t csoportban statisztikailag szignifik&aacute;ns javul&aacute;st tapasztaltunk a VAS- &eacute;s &eacute;letminős&eacute;g-pontsz&aacute;mok tekintet&eacute;ben (p &lt; 0,05).</p>.
Conclusion UNASSIGNED
<p>A spinalis &eacute;rz&eacute;stelenít&eacute;s nagyon hat&eacute;kony m&oacute;dszernek tűnik az &aacute;gy&eacute;ki &eacute;s thoracolumbalis gerincműt&eacute;tekn&eacute;l. Gondos betegkiv&aacute;laszt&aacute;s mellett ennek a rendkív&uuml;l hat&eacute;kony m&oacute;dszernek az alkalma&shy;z&aacute;sa k&eacute;nyelmes teret biztosít a seb&eacute;sz sz&aacute;m&aacute;ra.</p>.

Autres résumés

Type: Publisher (hun)
<p>A gerincseb&eacute;szet fontos&nbsp;he&shy;lyet foglal el az idegseb&eacute;szeti gyakorlatban. Az &aacute;gy&eacute;ki gerinc seb&eacute;szeti elj&aacute;r&aacute;sai k&ouml;&shy;z&eacute; tar&shy;tozik a stabiliz&aacute;ci&oacute;, a discectomia, a fo&shy;ra&shy;mi&shy;notomia &eacute;s a dekompresszi&oacute;. Az &aacute;gy&eacute;ki &eacute;s als&oacute; mellkasi gerincműt&eacute;tek biztons&aacute;gosan v&eacute;gezhetők spinalis aneszt&eacute;zi&aacute;ban (SA). A ge&shy;rincvelői &eacute;rz&eacute;stelenít&eacute;s biztons&aacute;goss&aacute;&shy;g&aacute;&shy;r&oacute;l &eacute;s hat&eacute;konys&aacute;g&aacute;r&oacute;l azonban nem sok tanulm&aacute;ny &aacute;ll rendelkez&eacute;sre a hossz&uacute;szeg&shy;mentum-stabiliz&aacute;ci&oacute;s műt&eacute;ten &aacute;tesett betegek eset&eacute;ben.</p>.

Identifiants

pubmed: 38051686
doi: 10.18071/isz.76.0415
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

415-421

Auteurs

Mehmet Huseyin Akgul (MH)

Department of Neurosurgery, Yuksek Ihtisas Hospital, Kirikkale, Turkey.

Mehmet Yigit Akgun (MY)

Department of Neurosurgery, Koc University Hospital, Istanbul, Turkey.

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