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The Comparison of Fluoroscopy-Guided Epidural Anesthesia with Conscious Sedation and General Anesthesia for Endoscopic Lumbar Decompression Surgery: A Retrospective Analysis

Authors
 Seung Youn Kang  ;  Hae Sun Cho  ;  Jihwan Yi  ;  Hyeun Sung Kim  ;  Il Tae Jang  ;  Do-Hyeong Kim 
Citation
 WORLD NEUROSURGERY, Vol.159 : e103-e112, 2022-03 
Journal Title
WORLD NEUROSURGERY
ISSN
 1878-8750 
Issue Date
2022-03
MeSH
Analgesics ; Anesthesia, Epidural* ; Anesthesia, General ; Conscious Sedation* ; Decompression ; Fluoroscopy ; Humans ; Pain, Postoperative ; Retrospective Studies
Keywords
Analgesia ; Conscious sedation ; Degenerative spine disease ; Endoscopic lumbar decompression surgery ; Epidural anesthesia ; Postoperative recovery
Abstract
Background: With advances and refinements in endoscopic lumbar spine surgery showing effective and satisfactory results, the need for simple yet effective anesthetic techniques for minimally invasive endoscopic spine surgery has increased. The aim of this study was to compare feasibility and postoperative outcomes of fluoroscopy-guided epidural anesthesia with general anesthesia in patients undergoing endoscopic lumbar decompression surgery (≤3 levels).

Methods: Patients who underwent 1-3 levels of endoscopic lumbar decompression surgery under either fluoroscopy-guided epidural or general anesthesia between January 2019 and October 2020 were retrospectively reviewed. Postoperative pain intensity and use of rescue analgesics for up to 48 hours were compared between the epidural and general anesthesia groups. Intraoperative anesthetic data and postoperative recovery profiles were also analyzed.

Results: Postoperative pain scores were significantly lower in the epidural anesthesia group compared with the general anesthesia group at 10 minutes after recovery room admission (2.1 ± 1.8 vs. 5.7 ± 1.9, P < 0.001), 24 hours postoperatively (3.3 ± 1.0 vs. 5.4 ± 1.8, P < 0.001), and 48 hours postoperatively (3.2 ± 0.6 vs. 4.4 ± 1.4, P < 0.001). The proportion of patients requiring rescue analgesics in the recovery room was significantly lower in the epidural anesthesia group (1.9% vs. 20.5%, P = 0.027). The median 15-item Quality of Recovery score on postoperative day 1 was significantly higher in the epidural anesthesia group (118.0 [113.5-123.0] vs. 82.0 [73.5-111.5], P < 0.001). Occurrence of nausea, vomiting, and voiding difficulty up to 48 hours postoperatively did not differ between groups.

Conclusions: Compared with general anesthesia, epidural anesthesia provided better analgesia and recovery characteristics during the early postoperative period in endoscopic lumbar decompression surgery.
Full Text
https://www.sciencedirect.com/science/article/pii/S1878875021018623
DOI
10.1016/j.wneu.2021.12.019
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Hyeong(김도형) ORCID logo https://orcid.org/0000-0003-2018-8090
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188403
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