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Regional anaesthesia is more preferred over general anaesthesia in high risk surgeries due to benefits such as rapid onset of action, and less pulmonary complications.
According to a recently done research by the investigators of Bansal Hospital, Bhopal, India, spinal anaesthesia (SA) is a reliable, satisfactory and safe substitute to general anaesthesia during high-risk lumbar spine surgeries as it reduces postoperative morbidity and mortality, and provides good perioperative hemodynamic stability.
Participants obtained a heavy spinal dose of Bupivacaine in the sitting position. Once the sensory level achieved, participants were shifted to the prone position. Hemodynamic parameters were observed throughout the surgery. Patients were shifted to the supine position at the end of operation and taken out of the operating room to the recovery room for monitoring. Patients were assessed for nausea and vomiting incidence, spinal headache, regression of sensory block, time spent in the postanesthesia care unit, urinary retention, analgesic use, hemodynamic changes, and length of hospital stay. The level of satisfaction in both surgeon and patients were also evaluated.
A total of 18 high-risk participants with lumbar spine disease were selected for the operation. Six were classified as American Society of Anesthesiologists III and twelve as American Society of Anesthesiologists IV. Eight went through canal and lateral recess decompression, and ten through microdiscectomy. No surgical or anaesthetic complications or postoperative vomiting or urinary retention were noticed. A significant relief in postoperative pain was seen. Only two participants exhibited the incidences of nausea. The level of satisfaction was high in both surgeons and patients. In comparison to the general anaesthesia, the SA was 12% cheaper. All these findings make SA is a suitable alternative to general anaesthesia.
World Neurosurg
Lumbar spine surgeries under spinal anaesthesia in high risk patients: A retrospective analysis.
Harshad Patil et al.
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