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

Abstract

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.

A review of the haematopoietic stem cell donation experience: is there room for improvement?

“…This strongly suggests that the choice of anaesthesia depends on the donor or the anaesthetist's preference. 18 Jobs involving mild to moderate daily work activities have been associated with fewer of days off work following BM donation compared with jobs involving more heavy duties. 17 Blood donors had more physical difficulty with donation; their previous experience with blood donation may have led them to underestimate the physical impact of BM donation.…”

“…60 There are few reports that compare general versus regional anaesthesia for BM harvesting. 11,18,[61][62][63] Local anaesthesia has reduced risk of trauma, because the patient is awake and vigilant, whereas general anaesthesia may produce a minor respiratory risk, because the donor has a secured airway. 64 Most studies found no difference regarding numbers of adverse events during or after the procedure.…”

“…In many centres, autologous red cell units are collected before the harvest. [17][18][19] Others see no need to collect autologous units arguing that red cell donation renders donors anaemic on the day of surgery, making transfusion-autologous or even allogeneic-more likely. 20 In addition, red cell donations often expire because of postponement of the donation.…”

Mobilization of Hematopoietic Stem Cells with Lenograstim in Healthy Donors: Efficacy and Safety Analysis According to Donor Age

“…o r g peripheral blood (PBSC) by apheresis [8]. BM harvest is performed under general or regional anesthesia [9], and stem cells are directly aspirated from both hip bones (posterior superior iliac crests). The complications of BM harvesting are well known and are usually mild and selflimiting.…”

Paravertebral blocks for analgesia following BM harvest

“…8 Most recently, a retrospective review of nearly 300 cases failed to demonstrate a clear advantage of regional anesthesia over general anesthesia for BM harvest, although satisfactory postoperative analgesia was not considered in that study and regional anesthesia was limited to subarachnoid block. 9 PVBs provide pre-emptive analgesia by blocking all sensory input, including sympathetic input from the surgical site prior to the injury. 10 They have been shown to reduce hospital stay, decrease postoperative nausea and vomiting, decrease blood loss and increase patient satisfaction.…”