Spinal anaesthesia versus general anaesthesia in the surgical microapproach of lumbar disc hernia

September 25, 2012

Spinal anaesthesia versus general anaesthesia in the surgical microapproach of lumbar disc hernia

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Title:	Spinal anaesthesia versus general anaesthesia in the surgical microapproach of lumbar disc hernia
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Article_Title:	Spinal anaesthesia versus general anaesthesia in the surgical microapproach of lumbar disc hernia
Authors:	Maria Stoica, Daniela Cernea, Luminiţa Chiuţu, Niculescu D., Purcaru F.
Affiliation:	1 Clinic of AIC, Universitary Emergency Hospital No.1 Craiova, University of Medicine and Pharmacy Craiova 2 Clinic of Orthopedics and Traumatology, Universitary Emergency Hospital No.1 Craiova, University of Medicine and Pharmacy Craiova
Abstract:	Objectives . The authors’ aim is to demonstrate the systemic impact of spinal anaesthesia compared with general anaesthesia in the minimal incision approach of lumbar disc hernia. Matherial & Method. There are studied two groups of patients, respectively: 22 patients who received general anaesthesia and 24 patients who received spinal anaesthesia; in both groups there were measured : clinical parameters (the time spent in PACU, the patient’s satisfaction regarding the type of anaesthesia, the level of pain using VAS at 1, 6 and 12 hours, the passed time until the first analgetic request, total quantity of used analgetics, functional recovery, nausea, vomiting, urinary retention, number of days of hospitalization) and biological parameters: glycemia, serum cortisol, hGH. Results and Conclusions. The results demonstrate the superiority of spinal anaesthesia in lumbar microdiscectomy with a high level of patient satisfaction and a good functional recovery.
Keywords:	lumbar disk hernia, discectomy, spinal anaesthesia, pain, endocrine stress
References:	Bagry HS, Raghavendran S, Carli F, Phil M. Metabolic syndrome and insulin resistance. Perioperative considerations. Anaesthesiology; 108(3);506-23, 2008. Baylot D, Navez ML. Place des blocs analgesique dans la prevention de la douleur chronique postoperatoire. Doul. et Analg.; 22(1):26-29, 2009. Cedraschi C, Allaz A-F. Les lombalgies et leur prise en charge chirurgicale: le role des facteurs psychosociaux. Doul et Analg., 19(3):55-58, 2006. Copaciu Elena. Actualitati in managementul durerii lombare. Revista Durerea, Nr. 2, 2006. Dagher C, Naccache N, Narchi P, Hage P, Antakly M-C. Anesthesie locoregionale pour cure microchirurgicale des hernies discales lombaires. Journal Medical Libanais 50 :206-210, 2002. Desborough JP. The stress response to trauma and surgery. Br. J. Anaesth. 85 (1):109-117, 2000. Fischer B. Does regional anaesthesia improve outcome?. Anaesthesia & Intensive Care Medicine 10 (11)545-548, 2009. Gotfryd A, Avanzi O. A systematic review of randomised clinical trials using posterior discectomy to treat lumbar disk herniations International Orthopaedics (SICOT); 33(1);11-17, 2009. Hall GM. The anaesthetic modification of the endocrine and metabolic response to surgery. Anals of the Royal Colege of Surgeons of England, 67(1):25-9, 1985. Huskisson EC. Visual analogue scales. In: Melzack R, editor. Pain measurement and assessment. New York: Raven Press;. p. 33-37, 1983. Liu CC, Kuo TB, Yang CC . Effects of estrogen on genderrelated autonomic differences in humans. Am J Physiol Heart Corc Physiol 285 (5):H2188-H93, 2003. McLain RF, Kalfas I, Bell GR. Comparison of Spinal and General Anesthesia in Lumbar Laminectomy Surgery : A Case-Controlled Analysis of 400 Patients. J Neurosurg : Spine, 2(1):17-22, 2005. Moore CM, Dersbrough JP, Powell H, Burrin JM, Hall GM. The effects of extradural anaesthedia on interleukin-6 and acute phase response to surgery. Br J Anaesth 72(3):272-9, 1994. Ouattara A. Le controle glycemique en perioperatoire. Annales Francaises d’ Anesthesie et de Reanimation 28(5); e217-e219, 2009. Perez JR, Tambe A, Dua R, Pereda E, Calthorpe D. Spinal or General anaesthesia for lumbar spine microdiscectomy Surgery…does it matter ? The internet Journal of Spine Surgery, Volume 3 (2); 2007. Smith YR, Stohler CS, Nichols TE, et al. Pronociceptive opiod and antinociceptive effects of estradiol through endogenous opiod neurotransmission in women. J Neurosci; 26(21):5777–578, 2006. Singh M. Stress reponse and anaesthesia altering the peri and post-operative management. Indian J. Anaesth; 47(6):427-434, 2003. Tousignant-Laflamme Y. Une revue sur les differences entre les hommes et les femmes au niveau de la reactivite autonomique a la douleur. Douleur analg. 22(3):152-156, 2009. Velickovic I, Yan J, Gross JA. Modifying the neuroendocrine stress response. Seminars in Anaesthesia, Perioperative Medicine and Pain; 21(1), 16-25, 2002.
Read_full_article:	pdf/21-2011/21-3-2011/SU21-3-2011-Stoica.pdf
Correspondence:	Tabaci Street, No. 1, 200642, Craiova, Dolj County, Department of Anaesthesia and Intensive Care Tel: +40742052313; E-mail: alin.stoica76@gmail.com

	Read full article
Article Title:	Spinal anaesthesia versus general anaesthesia in the surgical microapproach of lumbar disc hernia
Authors:	Maria Stoica, Daniela Cernea, Luminiţa Chiuţu, Niculescu D., Purcaru F.
Affiliation:	1 Clinic of AIC, Universitary Emergency Hospital No.1 Craiova, University of Medicine and Pharmacy Craiova 2 Clinic of Orthopedics and Traumatology, Universitary Emergency Hospital No.1 Craiova, University of Medicine and Pharmacy Craiova
Abstract:	Objectives . The authors’ aim is to demonstrate the systemic impact of spinal anaesthesia compared with general anaesthesia in the minimal incision approach of lumbar disc hernia. Matherial & Method. There are studied two groups of patients, respectively: 22 patients who received general anaesthesia and 24 patients who received spinal anaesthesia; in both groups there were measured : clinical parameters (the time spent in PACU, the patient’s satisfaction regarding the type of anaesthesia, the level of pain using VAS at 1, 6 and 12 hours, the passed time until the first analgetic request, total quantity of used analgetics, functional recovery, nausea, vomiting, urinary retention, number of days of hospitalization) and biological parameters: glycemia, serum cortisol, hGH. Results and Conclusions. The results demonstrate the superiority of spinal anaesthesia in lumbar microdiscectomy with a high level of patient satisfaction and a good functional recovery.
Keywords:	lumbar disk hernia, discectomy, spinal anaesthesia, pain, endocrine stress
References:	Bagry HS, Raghavendran S, Carli F, Phil M. Metabolic syndrome and insulin resistance. Perioperative considerations. Anaesthesiology; 108(3);506-23, 2008. Baylot D, Navez ML. Place des blocs analgesique dans la prevention de la douleur chronique postoperatoire. Doul. et Analg.; 22(1):26-29, 2009. Cedraschi C, Allaz A-F. Les lombalgies et leur prise en charge chirurgicale: le role des facteurs psychosociaux. Doul et Analg., 19(3):55-58, 2006. Copaciu Elena. Actualitati in managementul durerii lombare. Revista Durerea, Nr. 2, 2006. Dagher C, Naccache N, Narchi P, Hage P, Antakly M-C. Anesthesie locoregionale pour cure microchirurgicale des hernies discales lombaires. Journal Medical Libanais 50 :206-210, 2002. Desborough JP. The stress response to trauma and surgery. Br. J. Anaesth. 85 (1):109-117, 2000. Fischer B. Does regional anaesthesia improve outcome?. Anaesthesia & Intensive Care Medicine 10 (11)545-548, 2009. Gotfryd A, Avanzi O. A systematic review of randomised clinical trials using posterior discectomy to treat lumbar disk herniations International Orthopaedics (SICOT); 33(1);11-17, 2009. Hall GM. The anaesthetic modification of the endocrine and metabolic response to surgery. Anals of the Royal Colege of Surgeons of England, 67(1):25-9, 1985. Huskisson EC. Visual analogue scales. In: Melzack R, editor. Pain measurement and assessment. New York: Raven Press;. p. 33-37, 1983. Liu CC, Kuo TB, Yang CC . Effects of estrogen on genderrelated autonomic differences in humans. Am J Physiol Heart Corc Physiol 285 (5):H2188-H93, 2003. McLain RF, Kalfas I, Bell GR. Comparison of Spinal and General Anesthesia in Lumbar Laminectomy Surgery : A Case-Controlled Analysis of 400 Patients. J Neurosurg : Spine, 2(1):17-22, 2005. Moore CM, Dersbrough JP, Powell H, Burrin JM, Hall GM. The effects of extradural anaesthedia on interleukin-6 and acute phase response to surgery. Br J Anaesth 72(3):272-9, 1994. Ouattara A. Le controle glycemique en perioperatoire. Annales Francaises d’ Anesthesie et de Reanimation 28(5); e217-e219, 2009. Perez JR, Tambe A, Dua R, Pereda E, Calthorpe D. Spinal or General anaesthesia for lumbar spine microdiscectomy Surgery…does it matter ? The internet Journal of Spine Surgery, Volume 3 (2); 2007. Smith YR, Stohler CS, Nichols TE, et al. Pronociceptive opiod and antinociceptive effects of estradiol through endogenous opiod neurotransmission in women. J Neurosci; 26(21):5777–578, 2006. Singh M. Stress reponse and anaesthesia altering the peri and post-operative management. Indian J. Anaesth; 47(6):427-434, 2003. Tousignant-Laflamme Y. Une revue sur les differences entre les hommes et les femmes au niveau de la reactivite autonomique a la douleur. Douleur analg. 22(3):152-156, 2009. Velickovic I, Yan J, Gross JA. Modifying the neuroendocrine stress response. Seminars in Anaesthesia, Perioperative Medicine and Pain; 21(1), 16-25, 2002.
*Correspondence:	Tabaci Street, No. 1, 200642, Craiova, Dolj County, Department of Anaesthesia and Intensive CareTel: +40742052313; E-mail: alin.stoica76@gmail.com

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