General anaesthesia versus combined spinal plus general anaesthesia for elective lumbar spine surgeries: A randomized comparative study
Journal Title: Medpulse International Journal of Anesthesiology - Year 2017, Vol 4, Issue 1
Abstract
Background: Lumbar spine surgeries are most commonly performed under general anaesthesia. It allows better patient satisfaction and prolong surgeries but can be accompanied by several perioperative morbidities. Spinal anaesthesiain such cases gives excellent patient compliance and good surgical exposure with bloodless field. Aim: To compare the intra-operative variables and post-operative outcome after general anaesthesia versus combined spinal plus general anaesthesia in patients undergoing elective lumbar spine surgery. Material and Methods: A total of 60 adult cases from both sexes were randomly grouped into group A (received general anaesthesia) and group B (received spinal, Heavy 0.5%Bupivacaine plus Clonidine 30 μg, plus general anaesthesia). Results: Hemodynamics (mean pulse rate, systolic and diastolic blood pressure) at time of intubation (0min.), intraoperatively (10, 20, 30, 60, 90, 120 min.) and postoperatively (150, 180 min.) were significantly stable in Group B than Group A (p<0.05). Surgeon's satisfaction was higher in Group B than Group A. None of patients in both groups had bradycardia. In group A, 2 out of 30 patients had vomiting and there was no incidence of vomiting in group B. In group B 3 out of 30 patients had urinary retention while there was no incidence of urinary retention group A.Group A had post-operative analgesia 41.17±11.27 minutes and in Group B it was 396.16±47.80 minutes (p<0.05). The need of rescue analgesics was more in Group A than in Group B. Conclusion: Considering hemodynamic stability, profound and prolonged pain relief, significant decrease in blood loss, duration of surgery and need of anaesthetic agents with spinal anaesthesia and securing airway with general anaesthesia, combined spinal anaesthesia with general anaesthesia is safe and better technique than general anaesthesia alone for elective lumbar spine surgeries.
Authors and Affiliations
Gutte Shreyas Hanumant, Kamat Shriganesh Dayanand, Agrawal Pushpa
Keywords
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