Lomber dekompresyon cerrahisinde spinal ve genel anestezinin perioperatif sonuçlarının karşılaştırılması

Öz

Amaç: Lomber dekompresyon cerrahisi, disk herniasyonu ve spinal stenoz dahil olmak üzere dejeneratif omurga rahatsızlıklarında sıklıkla kullanılan bir tekniktir. Bu çalışmada, genel anestezi (GA) veya spinal anestezi (SA) ile lomber dekompresyon ameliyatı geçiren hastaların perioperatif sonuçları karşılaştırılmıştır. Yöntemler: Füzyon/enstrümantasyon yapılmadan lomber dekompresyon ameliyatı geçiren 1152 hasta retrospektif olarak incelenmiştir. Hastalar iki gruba ayrılmıştır: GA (n=516) ve SA (n=636). Ameliyat süresi, intraoperatif kan kaybı, preoperatif ve postoperatif VAS ve ODI skorları, mobilizasyon süresi, hastanede kalış süresi ve komplikasyonlar analiz edilmiştir. Sonuçlar: SA grubunda postoperatif erken VAS skorları daha iyi, mobilizasyon süresi ve hastanede kalış süresi daha kısaydı. İntraoperatif kan kaybı da SA grubunda daha düşüktü (p<0.001). Komplikasyonlara gelince; baş ağrısı SA grubunda daha sık görülürken, bulantı/kusma GA grubunda daha belirgindi. Gruplar arasında major komplikasyon oranları benzerdi. Sonuç: Spinal anestezi, genel anesteziye kıyasla lomber dekompresyon ameliyatlarında perioperatif dönemde çeşitli avantajlar sağlamaktadır. Anestezi seçimi, hasta profiline ve cerrahi karmaşıklığa bağlı olarak kişiselleştirilmelidir.

Anahtar Kelimeler

• spinal anesthesia
• general anesthesia
• lumbar decompression
• postoperative pain
• perioperative outcome

Perioperative Comparison of Spinal vs General Anesthesia in Lumbar Decompression Surgery

Öz

Aim: Lumbar decompression surgery is a frequently utilized technique in degenerative spine conditions including disc herniation and spinal stenosis. In this study, the perioperative outcomes of patients undergoing lumbar decompression with either general anesthesia (GA) or spinal anesthesia (SA) are compared. Methods: 1152 patients who underwent lumbar decompression surgery without fusion/instrumentation were retrospectively reviewed. Patients were categorized into two groups: GA(n=516) and SA (n=636). Duration of operation, intraoperative blood loss, preoperative and postoperative VAS and ODI scores, time to mobilization, length of hospital stay and complications were analyzed. Results: SA group showed better postoperative early VAS scores, shorter time to mobilization and length of hospital stay. Intraoperative blood loss was also lower in the SA group (p<0.001). Regarding the complications; while headache was more frequent in the SA group, nausea/vomiting was more prominent in the GA group. The rate of major complications were similar between groups. Conclusion: Spinal anesthesia provides several perioperative advantages in lumbar decompression surgery when compared with general anesthesia. Anesthesia choice should be personalized depending on the patient profile and surgical complexity.

Anahtar Kelimeler

• spinal anesthesia
• general anesthesia
• lumbar decompression
• postoperative pain
• perioperative outcome

Kaynakça

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