A prospective randomized study comparing perioperative outcome variables after epidural or general anesthesia for lumbar disc surgery.

Abstract

General and regional anesthesia (spinal and epidural) can be performed successfully for lumbar disc surgery. The aim of this study was to assess the superiority of general anesthesia or epidural anesthesia techniques in lumbar laminectomy and discectomy. Sixty patients undergoing lumbar partial hemilaminectomy and discectomy were randomly divided into two groups receiving standardized general anesthesia (GA) or epidural anesthesia (EA). Demographically, both groups were similar. Surgical onset time (36.72 +/- 5.47 vs. 25.40 +/- 7.83 minutes) was longer in the EA group, but total anesthesia time (154.32 +/- 35.73 vs. 162.40 +/- 26.79 minutes) did not differ between the two groups. Surgical time (118.80 +/- 35.42 vs. 139.60 +/- 26.80 minutes) was longer in the GA group. The heart rate and mean arterial pressure values of the EA group measured 15, 20, and 25 minutes after local anesthetic administration to the epidural catheter were found to be lower than in the GA group measured after induction of general anesthesia. The frequency of bradycardia (EA vs. GA, 3 vs. 2), tachycardia (3 vs. 7), and hypotension (6 vs. 4) during anesthesia did not differ between the groups, but the occurrence of hypertension (1 vs. 7) was higher in the GA group. Blood loss was less in the EA group than in the GA group (180.40 +/- 70.38 vs. 288.60 +/- 112.51 mL). Postanesthesia care unit (PACU) heart rate and mean arterial pressure were higher in the GA group. Peak pain scores in PACU and postoperative 24 hours were higher in the GA group when compared with the EA group. Nausea was more common in the GA group both in PACU and 24 hours after surgery. There was no difference between the hospitalization duration of the groups. In conclusion, this study suggests that EA is an important alternative to GA during lumbar disc surgery.