Sadrolsadat Seyed Hossein, Mahdavi Ali Reza, Moharari Reza Shariat, Khajavi Mohammad Reza, Khashayar Patricia, Najafi Atabak, Amirjamshidi Abbas
Sina Hospital, Medical Sciences/University of Tehran, Tehran, Iran.
Surg Neurol. 2009 Jan;71(1):60-5; discussion 65. doi: 10.1016/j.surneu.2008.08.003.
General anesthesia and regional anesthesia have both been shown to be suitable techniques for patients undergoing lower thoracic and lumbar spine surgery; however, GA is the most frequently used method. The purpose of this study was to conduct an acceptable RCT to compare the intraoperative parameters and postoperative outcome after SA and GA in patients undergoing elective lumbar disk surgery.
Patients undergoing laminectomy for herniated lumbar disk during the years 2005 and 2007 were enrolled. They were randomly selected to undergo GA and SA. The variables recorded during the operation were the patients' HR, MAP, amount of blood loss, and surgeons' satisfaction with the operating conditions. The severity of pain, nausea, vomiting, and length of stay in the hospital were recorded in the postoperative course.
The mean blood loss was less in the group undergoing GA; however, the difference was not statistically significant. The surgeon's satisfaction was reported to be higher in the GA group. No major intraoperative complication was reported in either series. During the recovery period, hypertension was reported to happen more frequently in the patients undergoing GA; and postoperative nausea and vomiting were more frequent among patients recovering from SA.
Contrary to previous studies, the findings of the present study revealed that SA has no advantages over GA. Moreover, it was showed that GA can reduce the related risks and complications in several aspects.
全身麻醉和区域麻醉已被证明都是适用于下胸椎和腰椎手术患者的技术;然而,全身麻醉是最常用的方法。本研究的目的是进行一项可接受的随机对照试验,以比较择期腰椎间盘手术患者蛛网膜下腔麻醉(SA)和全身麻醉(GA)后的术中参数和术后结果。
纳入2005年至2007年期间因腰椎间盘突出症接受椎板切除术的患者。他们被随机选择接受全身麻醉和蛛网膜下腔麻醉。手术期间记录的变量包括患者的心率、平均动脉压、失血量以及外科医生对手术条件的满意度。术后记录疼痛的严重程度、恶心、呕吐和住院时间。
接受全身麻醉的组平均失血量较少;然而,差异无统计学意义。据报道,全身麻醉组外科医生的满意度更高。两个系列均未报告重大术中并发症。在恢复期,据报道全身麻醉患者高血压发生更频繁;蛛网膜下腔麻醉恢复患者术后恶心和呕吐更频繁。
与先前的研究相反,本研究结果显示蛛网膜下腔麻醉并不优于全身麻醉。此外,研究表明全身麻醉可以在几个方面降低相关风险和并发症。