Spinal anesthesia for L5-S1 interlaminar endoscopic lumbar discectomy: a retrospective study
Abstract Objective This study aimed to report our experience with spinal anesthesia (SA) in patients undergoing L5-S1 interlaminar endoscopic lumbar discectomy (IELD) and clarify its advantages and disadvantages. Methods One hundred twelve patients who underwent IELD for an L5-S1 disc herniation und...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-023-06956-z |
| _version_ | 1797578616226185216 |
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| author | Guanyi Liu Jinsong Zhao Liyong Yuan Fangling Shi Liangguang Zhang |
| author_facet | Guanyi Liu Jinsong Zhao Liyong Yuan Fangling Shi Liangguang Zhang |
| author_sort | Guanyi Liu |
| collection | DOAJ |
| description | Abstract Objective This study aimed to report our experience with spinal anesthesia (SA) in patients undergoing L5-S1 interlaminar endoscopic lumbar discectomy (IELD) and clarify its advantages and disadvantages. Methods One hundred twelve patients who underwent IELD for an L5-S1 disc herniation under SA were retrospectively analyzed. SA with 0.5% ropivacaine was administered using a 27-gauge fine needle. Intraoperatively, the volume and level of SA, surgical time, blood loss, and cardiopulmonary complications were documented. Postoperative data was collected included the number of patients who ambulated on the day of surgery, incidence of complications and were then statistically analyzed. Results Analgesia was complete throughout the entire operation in all patients and no other adjuvant intraoperative analgesic drugs were needed. Mean visual analog scale scores for intraoperative and early postoperative (24 h) pain were 0 and 2.43 ± 1.66. SA was administered at the L3-4 interspace in 34 patients (30.4%) and the L2-3 interspace in 78 (69.6%). Administration was successful with the first attempt in all patients. Mean operation time was 70.12 ± 6.52 min. Mean intraoperative blood loss volume was 20.71 ± 5.26 ml. Ninety-eight patients ambulated on the same day as surgery. Mean length of hospital stay was 24.36 ± 3.64 h. Dural injury without damaging the nerve root occurred in one patient. One patient experienced recurrent disc herniation. Intraoperative hypotension and respiratory distress occurred in five (4.5%) and three (2.7%) patients, respectively. Three patients (2.7%) received postoperative analgesia therapy and two (1.8%) experienced nausea. Two patients (1.8%) developed urinary retention. Spinal headache, cauda equina syndrome, and neurotoxicity did not occur. Conclusion SA can achieve satisfactory pain control for patients undergoing IELD with a low incidence of adverse events. SA may be a useful alternative to local and general anesthesia for IELD surgery. Future randomized controlled trials are warranted to investigate. |
| first_indexed | 2024-03-10T22:25:20Z |
| format | Article |
| id | doaj.art-a58f0f6f1d3e4940893cf8e2369a3c81 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-10T22:25:20Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-a58f0f6f1d3e4940893cf8e2369a3c812023-11-19T12:09:03ZengBMCBMC Musculoskeletal Disorders1471-24742023-10-012411810.1186/s12891-023-06956-zSpinal anesthesia for L5-S1 interlaminar endoscopic lumbar discectomy: a retrospective studyGuanyi Liu0Jinsong Zhao1Liyong Yuan2Fangling Shi3Liangguang Zhang4Department of OrthopedicsDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of OrthopedicsDepartment of AnesthesiologyAbstract Objective This study aimed to report our experience with spinal anesthesia (SA) in patients undergoing L5-S1 interlaminar endoscopic lumbar discectomy (IELD) and clarify its advantages and disadvantages. Methods One hundred twelve patients who underwent IELD for an L5-S1 disc herniation under SA were retrospectively analyzed. SA with 0.5% ropivacaine was administered using a 27-gauge fine needle. Intraoperatively, the volume and level of SA, surgical time, blood loss, and cardiopulmonary complications were documented. Postoperative data was collected included the number of patients who ambulated on the day of surgery, incidence of complications and were then statistically analyzed. Results Analgesia was complete throughout the entire operation in all patients and no other adjuvant intraoperative analgesic drugs were needed. Mean visual analog scale scores for intraoperative and early postoperative (24 h) pain were 0 and 2.43 ± 1.66. SA was administered at the L3-4 interspace in 34 patients (30.4%) and the L2-3 interspace in 78 (69.6%). Administration was successful with the first attempt in all patients. Mean operation time was 70.12 ± 6.52 min. Mean intraoperative blood loss volume was 20.71 ± 5.26 ml. Ninety-eight patients ambulated on the same day as surgery. Mean length of hospital stay was 24.36 ± 3.64 h. Dural injury without damaging the nerve root occurred in one patient. One patient experienced recurrent disc herniation. Intraoperative hypotension and respiratory distress occurred in five (4.5%) and three (2.7%) patients, respectively. Three patients (2.7%) received postoperative analgesia therapy and two (1.8%) experienced nausea. Two patients (1.8%) developed urinary retention. Spinal headache, cauda equina syndrome, and neurotoxicity did not occur. Conclusion SA can achieve satisfactory pain control for patients undergoing IELD with a low incidence of adverse events. SA may be a useful alternative to local and general anesthesia for IELD surgery. Future randomized controlled trials are warranted to investigate.https://doi.org/10.1186/s12891-023-06956-zL5-S1 disc herniationPercutaneous endoscopic interlaminar lumbar discectomySpinal anesthesiaAdvantagesComplications |
| spellingShingle | Guanyi Liu Jinsong Zhao Liyong Yuan Fangling Shi Liangguang Zhang Spinal anesthesia for L5-S1 interlaminar endoscopic lumbar discectomy: a retrospective study BMC Musculoskeletal Disorders L5-S1 disc herniation Percutaneous endoscopic interlaminar lumbar discectomy Spinal anesthesia Advantages Complications |
| title | Spinal anesthesia for L5-S1 interlaminar endoscopic lumbar discectomy: a retrospective study |
| title_full | Spinal anesthesia for L5-S1 interlaminar endoscopic lumbar discectomy: a retrospective study |
| title_fullStr | Spinal anesthesia for L5-S1 interlaminar endoscopic lumbar discectomy: a retrospective study |
| title_full_unstemmed | Spinal anesthesia for L5-S1 interlaminar endoscopic lumbar discectomy: a retrospective study |
| title_short | Spinal anesthesia for L5-S1 interlaminar endoscopic lumbar discectomy: a retrospective study |
| title_sort | spinal anesthesia for l5 s1 interlaminar endoscopic lumbar discectomy a retrospective study |
| topic | L5-S1 disc herniation Percutaneous endoscopic interlaminar lumbar discectomy Spinal anesthesia Advantages Complications |
| url | https://doi.org/10.1186/s12891-023-06956-z |
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