Vural Cagil, Yorukoglu Dilek
Ankara University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Ankara, Turkey.
Turk Neurosurg. 2014;24(3):380-4. doi: 10.5137/1019-5149.JTN.8575-13.0.
The aim of this study was to evaluate patient satisfaction and cost in spinal and general anesthesia for lumbar disc surgery.
The study was performed on 66 ASA class I-II patients with one level lumbar disc herniation (LDH). In this prospective study, patients were assigned randomly to either spinal anesthesia or general anesthesia groups. Hemodynamic variables, intraoperative opioid requirements, postoperative pain scores and analgesic requirements and complications were recorded. Patients were handed a questionnaire about the procedure they underwent to determine patient satisfaction. The costs of preoperative and postoperative anesthesia procedures, medications, and hospitalization were calculated individually.
Spinal anesthesia and general anesthesia were similar concerning hemodynamic stability, first urination time, first mobilization time, postoperative analgesic requirement, and pain. Patients in group S needed less additional dose of fentanyl intraoperatively than the patients in group G. Patient satisfaction was significantly higher in Group S when compared to Group G. Total cost was higher in Group G compared to Group S.
We conclude that successful LDH surgery can be performed using either anesthesia type. As long as patients are selected carefully, spinal anesthesia is a safe, comfortable, and a more economical alternative.
本研究旨在评估腰椎间盘手术中脊髓麻醉和全身麻醉的患者满意度及成本。
本研究对66例美国麻醉医师协会（ASA）分级为I-II级的单节段腰椎间盘突出症（LDH）患者进行。在这项前瞻性研究中，患者被随机分配至脊髓麻醉组或全身麻醉组。记录血流动力学变量、术中阿片类药物需求量、术后疼痛评分及镇痛需求和并发症。向患者发放关于其接受手术过程的问卷以确定患者满意度。分别计算术前和术后麻醉程序、药物及住院的费用。
脊髓麻醉和全身麻醉在血流动力学稳定性、首次排尿时间、首次活动时间、术后镇痛需求及疼痛方面相似。S组患者术中所需芬太尼追加剂量低于G组患者。与G组相比，S组患者满意度显著更高。G组总成本高于S组。
我们得出结论，两种麻醉方式均可成功实施LDH手术。只要仔细选择患者，脊髓麻醉是一种安全、舒适且更经济的选择。
