Okan University, Department of Neurosurgery, Istanbul, Turkey.
Haydarpaşa Numune Training and Research Hospital, Department of Neurosurgery, Istanbul, Turkey.
Clin Neurol Neurosurg. 2020 Sep;196:106023. doi: 10.1016/j.clineuro.2020.106023. Epub 2020 Jun 20.
This study aims to show the feasibility of spinal anesthesia in lumbar spinal tumor surgery; share our data and experience.
A retrospective review of 14 patients with high risk for general anesthesia due to severe comorbidities was carried out. Patients who underwent surgeries under spinal anesthesia for lumbar vertebral column or spinal cord tumors at a single center between 2007-2019 were evaluated. The final pathological diagnosis, operation time, and surgical procedures were analyzed. Also, preoperative and postoperative advantages and disadvantages were determined. A comparison was performed with other 184 patients who were operated for spinal tumors in the same period under general anesthesia.
Maximum operation time was found 220 min, and the average operation time was 166 min. The most primary diagnosis was vertebral column metastasis. The mean age was 65.5 years. None of the patients required general anesthesia during surgery; however, two patients needed additional spinal anesthesia preoperatively, which was performed by the surgeon. Lumbar decompression and fusion were the most performed procedures.
Spinal anesthesia is a feasible and useful method of anesthesia in lumbar spinal tumor surgery for especially elderly patients with American Society of Anesthesiologists (ASA) 3 or 4 score and high risk of general anesthesia.
本研究旨在展示椎管内麻醉在腰椎脊柱肿瘤手术中的可行性；分享我们的数据和经验。
回顾性分析了 2007 年至 2019 年间在单一中心因严重合并症而不适合全身麻醉而行椎管内麻醉的 14 例腰椎脊柱或脊髓肿瘤患者。评估了在椎管内麻醉下接受腰椎脊柱或脊髓肿瘤手术的最终病理诊断、手术时间和手术过程。还与同期在全身麻醉下接受脊柱肿瘤手术的 184 例患者进行了比较。
最长手术时间为 220 分钟，平均手术时间为 166 分钟。最常见的初始诊断为脊柱转移瘤。平均年龄为 65.5 岁。无一例患者在手术中需要全身麻醉；然而，有 2 例患者在术前需要额外的椎管内麻醉，由外科医生进行。最常进行的手术是腰椎减压和融合。
椎管内麻醉是一种可行且有用的麻醉方法，尤其适用于美国麻醉医师学会（ASA）评分 3 或 4 级和全身麻醉风险高的老年腰椎脊柱肿瘤患者。
