A Prospective Randomized Study Comparing Short- and Intermediate-Term Perioperative Outcome Variables After Spinal or General Anesthesia for Lumbar Disk and Laminectomy Surgery

Jellish, W. Scott; Thalji, Zuhair; Stevenson, Kevin L.; Shea, John F.

doi:10.1097/00132586-199710000-00005

Cited by 19 publications

(51 citation statements)

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“…15 Berggren et al 15 Bigler et al 16 Casati et al 18 Davis et al 22 Davis et al 23 Eroglu et al 25 Hole et al 27 Jones et al 28 Juelsgaard et al 30 McKenzie et al 34 McLaren et al 35 Nielson et al 37 Racle et al 38 Riis et al 39 Valentin et al 41 White et al 42 Williams-Russo et al 43 Random = 0.00; Chi 2 = 14.80, df = 10 (P = 0.14); I 2 = 32% Test for overall effect: Z = 1.15 (P = 0.25) Test for subgroup differences: Chi 2 = 1.29, df = 2 (P = 0.53); I 2 = 0% not possible to pool the data for degree of satisfaction, blood transfusion requirements or quality of life. The data on the degree of satisfaction and blood transfusion requirements were not described correctly in the studies included.…”

Section: Discussionmentioning

confidence: 99%

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Neuraxial anesthesia for orthopedic surgery: systematic review and meta-analysis of randomized clinical trials

2013

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CONTEXT AND OBJECTIVE: Taking the outcome of mortality into consideration, there is controversy about the beneficial effects of neuraxial anesthesia for orthopedic surgery. SciELO, EMBASE (1974 to November 2012 and reference lists of the studies included. Only randomized controlled trials were included. RESULTS: Out of 5,032 titles and abstracts, 17 studies were included. There were no statistically significant differences in mortality (risk difference, RD: -0.01; 95% confidence interval, CI: -0.04 to 0.01; n = 1903), stroke (RD: 0.02; 95% CI: -0.04 to 0.08; n = 259), myocardial infarction (RD: -0.01; 95% CI: -0.04 to 0.02; n = 291), length of hospitalization (mean difference, -0.05; 95% CI: -0.69 to 0.58; n = 870), postoperative cognitive dysfunction (RD: 0.00; 95% CI: -0.04 to 0.05; n = 479) or pneumonia (odds ratio, 0.61; 95% CI: 0.25 to 1.49; n = 167). CONCLUSION: So far, the evidence available from the studies included is insufficient to prove that neuraxial anesthesia is more effective and safer than general anesthesia for orthopedic surgery. However, this systematic review does not rule out clinically important differences with regard to mortality, stroke, myocardial infarction, length of hospitalization, postoperative cognitive dysfunction or pneumonia. CONCLUSÃO: Até o momento, as evidências são insuficientes nos estudos incluídos para provar que AN é mais efetiva e segura do que AG para cirurgias ortopédicas. Esta revisão sistemática não descartou diferenças clínicas importantes para mortalidade, acidente vascular encefálico, infarto miocárdico, tempo de internação, disfunção cognitiva pós-operatória e pneumonia. RESUMO IMSc. Professor,

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Section: Discussionmentioning

confidence: 99%

“…Fifteen of these were subsequently excl uded. 13,14,17,19,20,21,24,26,28,[31][32][33]36,40,43 The reasons for their exclusion can be seen in Figure 1. Thus, 17 articles with the potential to answer our research question were identified.…”

Section: Study Selectionmentioning

confidence: 99%

Neuraxial anesthesia for orthopedic surgery: systematic review and meta-analysis of randomized clinical trials

2013

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“…These benefits include (1) reduced blood loss intra-operatively because of decreasing peripheral venous pressure; (2) patients' ability to change the position of arms, legs and chest, as needed to avoid nerve injury, brachial plexus palsy or pressure necrosis in either the face or chest wall; (3) reduced incidence of nausea and vomiting postoperatively; (4) better postoperative analgesia; (5) decreased stress response; (6) preservation of immune response; (7) shorter hospitalisation time; as well as (8) cost reduction. 5,6,7,8,[9][10][11][12][13][14] These benefits of RA should counterbalance the risk of respiratory complications (including respiratory depression) in a sedated pronepositioned patient when compared with GA (with a secured airway). 14 Spinal and anorectal surgery are the procedures carried out in the same body position as that for BMH (the prone position).…”

Section: Discussionmentioning

confidence: 99%

“…However, studies on the choice of anaesthesia for anorectal surgery include many less patients than those for spinal surgery. In a prospective study of 122 patients who underwent lumbar disk and laminectomy surgery, Jellish et al 13 found RA superior to GA. For the RA group (61 patients), the authors reported shorter total anaesthesia and surgery time, lower incidence of increased blood pressure intra-operatively, less severe nausea and pain postoperatively, lower heart rates and mean arterial pressure postoperatively. This study, composed of a smaller number of patients, is the only completed and published prospective trial on the anaesthesia choice for spinal surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Similar findings have been reported by others while comparing GA with RA for BMH, as well as for another surgical procedures. 6,7,11,13,14 In an earlier retrospective study of 162 BM donations (63 allogeneic and 99 autologous), Lavi et al 4 found that patients who underwent GA required more RBC units than those undergoing RA. Our results do not confirm this finding.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of general vs regional anaesthesia for BM harvesting: a retrospective study of anaesthesia-related complications

Machaczka

Kalaitzakis

Eleborg

et al. 2009

Bone Marrow Transplant

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This retrospective study was conducted to evaluate the safety and complications profile of general anaesthesia (GA) compared with that of regional anaesthesia (RA) for BM harvesting (BMH). The study included 281 donations carried out between 1992 and 1999. Of these, 204 (73%) were allogeneic donations, and GA was carried out in 69% (140 of 204) and RA in 31% (64 of 204) of cases. The other 77 donations were autologous (27%), using GA in 87% (67 of 77) and RA in 13% (10 of 77) of cases. No life-threatening complications occurred, but there were minor intra-and postoperative events during 26 (9%) and after 58 (21%) donations. Postoperative nausea and vomiting was reported in 40 (14%) cases and post-spinal headache after five out of 58 (8.6%) donations in which spinal anaesthesia was carried out. The incidence of intraand postoperative events did not differ significantly between the GA and RA groups. However, the incidence of postoperative events was higher in the allogeneic group compared with that in the autologous group (25 vs 10%, Po0.01) and in female donors compared with male donors (29 vs 14%, P ¼ 0.002). In conclusion, both GA and RA are comparable with regard to BMH. Nevertheless, non-severe intra-and postoperative events were frequent.

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Survey of anesthesia practice in spine surgery patients in the United States

Blinder

El-Mansouri

Connelly

2003

Journal of Anesthesia

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A Prospective Randomized Study Comparing Short- and Intermediate-Term Perioperative Outcome Variables After Spinal or General Anesthesia for Lumbar Disk and Laminectomy Surgery

Cited by 19 publications

References 0 publications

Neuraxial anesthesia for orthopedic surgery: systematic review and meta-analysis of randomized clinical trials

Neuraxial anesthesia for orthopedic surgery: systematic review and meta-analysis of randomized clinical trials

Comparison of general vs regional anaesthesia for BM harvesting: a retrospective study of anaesthesia-related complications

Survey of anesthesia practice in spine surgery patients in the United States

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