AI Summary & Key Takeaways
AI InsightConclusion: Spinal anesthesia has advantages over TIVA with respect to reduced amount of blood loss, reduced total stay in the operation room and better postoperative analgesia for lumbar disk surgery.
📌 3 Key Takeaways
Abstract
Objective: We compared, total intravenous anesthesia (TIVA) and spinal anesthesia in lumbar disk surgery, with respect to surgical times, blood loss, hemodynamic effects and postoperative pain. Methods: Sixty ASA I-II patients, planned for lumbar disk surgery, were allocated into two groups. In Group S (n=30), spinal anesthesia was performed with 15 mg bupivacaine. When the T6-10 sensory level was achieved, the patient was turned to the prone position. In Group T (n=30), propofol and remifentanil infusions were administered. Anesthesia and surgical times, blood loss, perioperative mean arterial pressure (MAP), heart rate (HR) and postoperative pain scores were recorded. Results: Surgical onset and surgical time were similar (p>0.05). Blood loss and duration in the operating room (94.1±20.8 vs. 108.0±23.2 min) was less in Group S (p<0.05). MAP at 3rd min of anesthesia and HR at the 30, 40 and 50 min of surgery was less in Group T (p<0.002). Postoperative pain scores were higher in Group T (p<0.004). Patient and surgeon satisfaction scores were comparable (p>0.05). Conclusion: Spinal anesthesia has advantages over TIVA with respect to reduced amount of blood loss, reduced total stay in the operation room and better postoperative analgesia for lumbar disk surgery.
Özet
Amaç: Lomber omurga cerrahisinde spinal anestezi ve total intravenöz anestezi (TIVA) tekniklerinin operasyon süresi, kanama miktarı, hemodinamik özellikler, postoperatif ağrıya etkilerini değerlendirmektir. Yöntem: Lomber diskektomi ve/veya laminektomi operasyonu planlanan, ASA I-II risk grubu 60 hasta iki gruba ayrıldı. Grup S’de (n=30), 15 mg bupivakain ile spinal anestezi uygulamasından sonra duyu bloğu T6-10 seviyesine ulaşınca, yüzüstü pozisyon verildi. Grup T’de (n=30), propofol ve remifentanil ile TIVA gerçekleştirildi. Anestezi, operasyon süreleri, kanama miktarı, perioperatif ortalama kan basıncı (OKB), kalp hızı (KAH), postoperatif ağrı düzeyleri kaydedildi. Bulgular: Operasyona başlama ve operasyon süreleri gruplarda benzerdi (p>0,05). Grup S’de operasyon anında kanama miktarı, operasyon odasında kalış süresi (94,1±20,8 dk vs 108,0±23,2 dk) daha az izlendi (p 0.05). Sonuç: Operasyon anında kanama ve operasyon odasında kalış süresini azaltması; daha etkili postoperatif analjezi sağlaması nedeni ile spinal anestezi TIVA’ya alternatif olarak uygulanabilir.