Postoperative Recovery Profile Following Posterior Lumbar Laminectomy: A Comparative Study Of General Anaesthesia And Spinal Anaesthesia
Article Sidebar
Views | PDF/EPUB Download:
15
/ 8
/ 6
Main Article Content
Abstract
Background: Elective lumbar laminectomy can be done under both general and spinal anaesthesia. Many authors have suggested that the choice of anaesthetic technique influences postoperative recovery outcomes. Existing literature provides inconsistent findings regarding which technique offers superior recovery profile. Furthermore, there is paucity of well- designed comparative studies evaluating the recovery profile of patients who had lumbar laminectomy under spinal anaesthesia with those under general anaesthesia. This lack of conclusive evidence underscores need for further research to determine the optimal anaesthetic approach that enhances recovery profile.
Subjects and Methods: Fifty eligible patients were recruited and randomized into two groups (25 each) using block technique. Each group received either general anaesthesia or spinal anaesthesia. The discharge time from post anaesthetic care unit (PACU), pain scores at 4, 8, and 24hrs from the end of surgery, time at first ambulation and time of discharge from the hospital were assessed and recorded. The data were analyzed using Statistical Package for Social Sciences (SPSS) 26 for windows.
Results: The mean duration of PACU stay was comparable (GA.=74.44±3.94 mins, SA=73.56±14.44 mins, p = 0.770). The spinal anaesthesia group had a significantly (p=0.003) lower mean pain scores (3.323.32±0.9) than the general anaesthesia group (4.08±0.81) at 4hr from the end of the surgery, thereafter the pain scores became comparable. The time to first ambulation after surgery (GA=67.92±13.14hrs, SA=62.70±12.60hrs), and the time to hospital discharge (GA=7.56±1.53days, SA=7.16±1.41days) in both groups were comparable with P=0.158, P = 0.340 respectively.
Conclusion: Spinal anaesthesia offered a better early postoperative recovery profile than general anaesthesia, as evidenced by a lower pain score at 4hrs postoperative time.
Downloads
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
How to Cite
References
1. Patrick TO. A Brief History of evolution of Lumbar Spinal Surgical Decompression. J Spinal Res. Found. 2014;9(2):38-40.
2. Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery. The Lancet. 2003;362(9399):1921-1928.
3. Al-Fallouji M.A.R. Endocrine and metabolic changes after surgery In Postgraduate Surgery-The candidates guide 2nd ed. Butterworth-Heinemann, 1998 pg;29-32
4. Desborough JP. The stress response to trauma and surgery. Br J Anaesth. 2000;85:109-117. http: doi.org/10.1093/bja/85.1.109. [PubMed]
5. Kavanagh T, Buggy DJ. Can anaesthetic technique affect postoperative outcome. Curr. Opin in Anaesthesiol. 2012;25(2):185-198.
6. Attari MA, Mirhosseini SA, Honarmand A, Safavi MR. Spinal anaesthesia versus general anaesthesia for elective lumbar spine surgery: A randomised clinical trial. J Res Med Sci. 2011;16:524-529.
7. Mergeay M, Verster A, Van Aken D, Vercauteren M. Regional versus general anesthesia for spine surgery. A comprehensive review. Acta Anaesth. Belg. 2015;66(1):1-9.
8. Zorrilla-Vaca A, Healy RJ, Mirsky MA. A Comparison of Regional versus General Anesthesia for lumbar spine surgery: Meta-analysis of Randomized Studies. J. Neurosurg. Anesthesiol. 2017;29:415-425
9. Dagistan Y, Okmen K, Dagistan T, Guler A, Ozkan N, Lumbar microdiscectomy under spinal and general anaesthesia: a comparative study. Turk. Neurosurg. 2015;25:685-689.
10. Karaman S, Karaman T, Dogru S, Sahin A, Arici S, Tapar H. Retrospective evaluation of anaesthesia approaches for lumbar disc surgery J. Anaesth Clin. Res. 2014;5(4):402
11. Agarwal P, Pierce J, Welch WC. Cost analysis of spinal versus general anaesthesia for lumbar discectomy and laminectomy spine surgery. World Neurosurg. 2016;89:266-271
12. Walcott BP, Khanna A, Yanamadala V, Coumans JV, Petrefreund RA. Cost analysis of spinal and general anesthesia for the surgical treatment of lumbar spondylosis. J. Clin. Neurosci. 2015;22:539-543.
13. Gupta A, Saxena AK, Gupta A, Mohan A, Saxena A, Kumar C. Comparison of Spinal Anaesthesia Vs General Anaesthesia for lower spine surgeries. Int. Arch. Of Biomed. and Clin. Research. 2018;4(1):28.
14. Kara I, Celik JB, Bihar OC, Apilliogullari S, Karabagli H. Comparison of spinal and general anaesthesia in lumbar disc surgery. J NeurosurgSci Turk. 2011;28(4):487-496.
15. Lohchab I, Gupta R, Kumar A, Tanwar G, Shobha V. Comparison Of Perioperative Outcome Variables in Spinal Anaesthesia and General Anaesthesia for Elective Lumbar Laminectomy. Journal of Contemporary Clinical Practice. 2025; 11(2):25-34.
16. Kindris F, Zegarek G, Krappel FA, Perrig WN, Schmid SL. Spinal versus general anesthesia for lumbar decompression or sequestrectomy in patients over 75 years. Clin Spine Surg. 2023;36(7):E329-31.
17. Singeisen H, Hodel D, Schinder C, Frey K, Eichenberger U, Hausmann ON, et al. Significantly shorter anaesthesia time for surgery of the lumbar spine: process analytical comparison of spinal anaesthesia and intubation narcosis. Der Anaesth. 2013;62(8):632-638.
18. Mahajan BK. Methods in biostatistics. 2010;7:4:80-92. (New Delhi, Jaypee).
19. Finsterwald M, Muster M, Farshad M, Saporito A, Brada M, Aguirre JA. Spinal versus general anaesthesia for lumbar spine surgery in high-risk patients: perioperative haemodynamic stability, complications and cost. J Clin Anaesth. 2018;46:3-9.
20. Ganter MT, Stephan B, Seraina D, Simone B, Tim H, Richard K, et al. The length of stay in the post-anaesthesia care unit correlates with pain intensity, nausea and vomiting on arrival. Periop. Med. 2014;3(1):10.
21. Jellish WS, Edelstein S. Spinal anesthesia for lower level spine surgery. In: Victor M, Whizar-Lugo (ed). Topics in spinal Anaesthesia. Intech, 2014;19-38.
22. Kahveci K, Cihan D, Dilsen O, Derya G, Semih A. Perioperative outcome and cost-effectiveness of spinal versus general anesthesia for lumbar spine surgery. PJNNS. 2014;36:1-7.
23. John TP, Guy K, Mark AA, Micheal JK, Koenigsberg R, Syre P et al. Efficiency of spinal anesthesia versus general anesthesia for lumbar spinal surgery: a retrospective analysis of 544 patients. Local Reg Anesth. 2017;10:91-98.
24. Wang HL. Early Ambulation Is Crucial for Improving Patient Health. AJN 2017;116(6):15.
25. McClain RF, Kalfas I., Bell GR. , Tetzlaff JE., Yoon HJ., Rana M. Comparison of spinal and general anaesthesia in lumbar laminectomy surgery: a case-controlled analysis of 400 patients. J Neurosurg Spine. 2005;2:17-22.
26. Rodriguez JP, Tambe A, Dua R, Pereda E, Calthorpe D. Spinal or General anaesthesia for lumbar spine microdiscectomy surgery: --- does it matter? Orthopaedic Proceedings. 2012; 94:96-96.
27. Chen HT, Tsai CH, Chao SC, Kao TH, Chen YJ, Hsu HC, et al. Endoscopic discectomy of L5-S1 disc herniation via an interlaminar approach: prospective controlled study under local and general anesthesia. Surg Neurol Int. 2011;2:93