General anesthesia versus combined epidural/general anesthesia for elective lumbar spine disc surgery: A randomized clinical trial comparing the impact of the two methods upon the outcome variables

Abstract

Background:General anesthesia (GA) is the most frequently used technique for lumbar spine disc surgery. The aim of this study was to compare the intraoperative variables and postoperative outcome after GA and combined general/epidural anesthesia (CEG) in patients undergoing elective lumbar spine disk surgery.Methods:Eighty patients who underwent one or two level of laminectomy/discectomy during a 2 year period were enrolled in this randomized controlled trial (RCT). They were randomly selected to undergo GA or CEG. The data recorded during surgery were: The patients’ heart rate (HR), mean arterial blood pressure (MABP), amount of blood loss, and the medication used during anesthesia. The severity of pain score, total analgesic consumption, and complications were recorded in the postoperative period.Results:The MABP, HR, blood loss, and anesthetic medication were significantly lower in CEG group in comparison with that of GA group. In the postoperative period, the pain score and total analgesic requirement was lower in the CEG group and less complication were encountered in this group.Conclusion:The results of this study revealed that CEG have some advantages over GA in reducing the blood loss and anesthetic medication during the operation and it is also more effective in control of pain with fewer complications during the postoperative period.

Effect of different anesthetic methods on cellular immune functioning and the prognosis of patients with ovarian cancer undergoing oophorectomy

“…Similarly, Pei et al [ 22 ] demonstrated that epidural anesthesia can provide much better pain relief postoperation, reserve the ability of immune response caused by the stress response leading to an overall better prognosis. Moreover, Khajavi et al [ 23 ] reported that their requirement for analgesics were significantly reduced due to less pain experienced after a lumbar laminectomy procedure. Third, the 5-year survival rate of OC patients who were dosed with GEA was higher than those who received GA. Wang et al .…”

Dexmedetomidine versus fentanyl added to bupivacaine for epidural analgesia in combination with general anesthesia for elective lumbar disc operations: A prospective, randomized double-blinded study

“…Khajavi et al . [ 2 ] showed in their study that CGE analgesia could be a better alternative to general anesthesia alone in lumbar disc operations because the combination carries the advantages of both methods.…”

“…There is considerable acceptance for the use of epidural analgesia, which has minimal side effects, in spine surgery, taking into consideration the proper selection of patients and surgeons;[ 1 ] epidural analgesia provides an acceptable hemodynamic profile, especially when combined with general anesthesia. [ 2 ] However, most previous relevant studies have not addressed the type of drugs used for epidural analgesia in such operations.…”

Effects of two different anesthesia-analgesia methods on incidence of postoperative delirium in elderly patients undergoing major thoracic and abdominal surgery: study rationale and protocol for a multicenter randomized controlled trial

“…For patients undergoing major thoracic and abdominal surgery, neuraxial block can be performed in combination with general anesthesia. Studies showed that, compared with general anesthesia and postoperative intravenous analgesia, combined epidural-general anesthesia and postoperative epidural analgesia decreased the requirement of general anesthetics during surgery and provided better pain relief after surgery [ 36 – 39 ]. We hypothesize that combined epidural-general anesthesia and epidural analgesia may be superior to general anesthesia and intravenous analgesia in decreasing the incidence of postoperative delirium.…”