White-Dzuro Gabrielle A, Bao Xiaodong, McGovern Francis, Peterfreund Robert A
Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Department of Urology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Case Rep Anesthesiol. 2025 Apr 28;2025:7810025. doi: 10.1155/cria/7810025. eCollection 2025.
A patient with lumbar spine stenosis presented for lumbar spine decompression, clearly stating a preference for spinal anesthesia (SA) over general anesthesia (GA). Surgery was performed under uneventful SA without sedation. The patient recovered from surgery quickly and without incident, requiring no postoperative opioid analgesia. What data support administering SA for lumbar spine surgery? A literature search found nine recently published reviews favoring SA over GA. These reviews cited many of the same, older, flawed, primary research reports. Although choosing SA was reasonable, our literature analysis suggests blind reliance on summary conclusions of reviews and meta-analyses may be misleading.
一名腰椎管狭窄症患者接受腰椎减压手术,明确表示更倾向于脊髓麻醉(SA)而非全身麻醉(GA)。手术在未使用镇静剂的情况下顺利进行脊髓麻醉。患者术后恢复迅速且无并发症,无需术后使用阿片类镇痛药物。哪些数据支持在腰椎手术中使用脊髓麻醉?文献检索发现最近发表的九篇综述支持脊髓麻醉优于全身麻醉。这些综述引用了许多相同的、年代较久且有缺陷的原始研究报告。虽然选择脊髓麻醉是合理的,但我们的文献分析表明,盲目依赖综述和荟萃分析的总结结论可能会产生误导。