Comparison of spinal anesthesia and local anesthesia in percutaneous interlaminar endoscopic lumbar discectomy for L5/S1 disc herniation: a retrospective cohort study.
IELD
Interlaminar endoscopic lumbar discectomy
Local anesthesia
Spinal anesthesia
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
02 Oct 2024
02 Oct 2024
Historique:
received:
04
01
2024
accepted:
23
09
2024
medline:
3
10
2024
pubmed:
3
10
2024
entrez:
2
10
2024
Statut:
epublish
Résumé
Interlaminar endoscopic lumbar discectomy (IELD) is a prevalent method for managing lumbar disc herniation. Local anesthesia (LA) is frequently employed during IELD, albeit with its merits and drawbacks. The spinal anesthesia (SA) represents a feasible anesthetic strategy for IELD; however, the availability of clinical research data is currently limited. The propensity score matching was conducted to ensure the comparability of the SA and LA groups. The outcome measures were operation time, intraoperative visual analogue scale (VAS) for pain, need for adjuvant analgesia, intraoperative vital signs, blood loss, adverse surgical events, anesthesia-related complications, postoperative bed rest duration, VAS for pain at 2 h postoperatively, Oswestry Disability Index score (ODI), satisfaction with surgical efficacy, and willingness to undergo reoperation at 6 months postoperatively. Fifty-six patients were assigned to each group. Significant differences were found between the groups regarding intraoperative VAS for pain, use of adjuvant analgesics, willingness to undergo reoperation, maximum intraoperative systolic blood pressure, and variability (P < 0.05). Compared to the LA group, the SA group had lower VAS for pain at 2 h postoperatively, a longer operation time, a longer duration of postoperative bedrest, and more anesthesia-related complications (P < 0.05). No significant intergroup differences were detected in intraoperative heart rate variability, blood loss, ODI, satisfaction with surgical efficacy, and surgery-related complications (P > 0.05). SA as an alternative anesthesia for IELD surgery holds great promise, exhibiting superior efficacy compared to LA. However, it is crucial to meticulously evaluate the indications due to potential risks associated with this form of anesthesia.
Sections du résumé
BACKGROUND
BACKGROUND
Interlaminar endoscopic lumbar discectomy (IELD) is a prevalent method for managing lumbar disc herniation. Local anesthesia (LA) is frequently employed during IELD, albeit with its merits and drawbacks. The spinal anesthesia (SA) represents a feasible anesthetic strategy for IELD; however, the availability of clinical research data is currently limited.
METHODS
METHODS
The propensity score matching was conducted to ensure the comparability of the SA and LA groups. The outcome measures were operation time, intraoperative visual analogue scale (VAS) for pain, need for adjuvant analgesia, intraoperative vital signs, blood loss, adverse surgical events, anesthesia-related complications, postoperative bed rest duration, VAS for pain at 2 h postoperatively, Oswestry Disability Index score (ODI), satisfaction with surgical efficacy, and willingness to undergo reoperation at 6 months postoperatively.
RESULTS
RESULTS
Fifty-six patients were assigned to each group. Significant differences were found between the groups regarding intraoperative VAS for pain, use of adjuvant analgesics, willingness to undergo reoperation, maximum intraoperative systolic blood pressure, and variability (P < 0.05). Compared to the LA group, the SA group had lower VAS for pain at 2 h postoperatively, a longer operation time, a longer duration of postoperative bedrest, and more anesthesia-related complications (P < 0.05). No significant intergroup differences were detected in intraoperative heart rate variability, blood loss, ODI, satisfaction with surgical efficacy, and surgery-related complications (P > 0.05).
CONCLUSION
CONCLUSIONS
SA as an alternative anesthesia for IELD surgery holds great promise, exhibiting superior efficacy compared to LA. However, it is crucial to meticulously evaluate the indications due to potential risks associated with this form of anesthesia.
Identifiants
pubmed: 39358751
doi: 10.1186/s12891-024-07898-w
pii: 10.1186/s12891-024-07898-w
doi:
Types de publication
Journal Article
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
774Subventions
Organisme : Ningbo Public Welfare Research Plan Key Project
ID : No. 2023S036
Organisme : Ningbo "Science and Technology Yongjiang 2035" Science and Technology Innovation Ecological Incubation Plan
ID : No. 2024Z048
Organisme : Science and Technology Project for Agricultural and Social Development in Yinzhou District
ID : No. 2024AS036
Informations de copyright
© 2024. The Author(s).
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