Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Apr 2014
Review Comparative StudyRegional anesthesia versus general anesthesia for surgery on the lumbar spine: a review of the modern literature.
Lumbar spine surgery can be performed using different anesthetic techniques such as general endotracheal anesthesia (GA) or spinal-based regional anesthesia (RA). Several studies have been performed comparing these two anesthetic techniques and have revealed disparate results. As such, we set out to review the relevant literature. ⋯ Of these, 4 were randomized control trials, 3 were case control trials, 2 were prospective cohorts, and 2 retrospective analyses. Seven-out-of-seven studies reported reduced HRs and MAPs in the RA compared to GA group, and 7/9 studies reported a lower incidence of post-operative analgesic requirement and/or decreased pain scores for the RA group. Our review of the literature suggests that both RA and GA are safe and effective techniques for lumbar spine surgery and that RA may prove a better alternative than GA for healthy patients undergoing simple lumbar decompression procedures or for patients who are at high risk for general anesthetic complications.