Effects of Anesthesia Protocol on Perioperative Outcomes and Costs of Lumbar Microdiscectomies

Özet

AIM: To compare the effects of spinal anesthesia (SA) and general anesthesia (GA) in lumbar microdiscectomy in terms of their costeffectiveness, and perioperative outcomes.MATERIAL and METHODS: We randomly allocated 100 consecutive patients who were scheduled to undergo elective lumbarmicrodiscectomy, into either SA or GA groups.We recorded and evaluated various parameters, including demographic aspects, body mass index (BMI), perioperativehemodynamics, time elapsed from operating room (OR) entry until incision, operative time, time elapsed from application of thesurgical dressing to exiting OR, blood loss, post anesthetic care unit (PACU) time, preoperative and postoperative pain scores,postoperative analgesic requirements, first mobilization time, first oral intake, the length of hospital stay, time to return to work, andperioperative anesthetic costs. The patients, anesthesiologists, and neurosurgeons were handed a questionnaire before dischargeto determine their satisfaction with the procedure.RESULTS: Several variables were found to be better in the SA group: the mean arterial pressure and heart rate changes weresignificantly lower, and the time elapsed from OR entry until incision, operative time, time elapsed from application of the surgicaldressing to exiting OR, PACU time, the length of hospital stay, and time to return to work were shorter; furthermore, the postoperative pain scores, the analgesic requirements, the intraoperative blood loss, and the cost of anesthesia were all lower. Moreoverthe first mobilization and oral intake occurred earlier; and most significantly, the satisfaction of the patients and surgeons was higherin the SA group. Furthermore, we encountered no complications.CONCLUSION: Based on our results, we conclude that SA is reliable and clinically successful procedure in lumbar microdiscectomy.