scholarly journals EVALUATION OF PAIN SYNDROME AND EFFICIENCY OF PAIN MANAGEMENT IN LUMBAR SPINE SURGERY

2019 ◽  
Vol 6 ◽  
pp. 29-34
Author(s):  
Mykola Lyzohub ◽  
Marine Georgiyants ◽  
Kseniia Lyzohub
Keyword(s):  
Neuropathic Pain ◽  
Lumbar Spine ◽  
Pain Management ◽  
Spinal Anesthesia ◽  
Spine Surgery ◽  
Multimodal Analgesia ◽  
Opioid Consumption ◽  
Total Intravenous Anesthesia ◽  
Lumbar Spine Surgery ◽  
Intravenous Anesthesia

Multimodal analgesia for lumbar spine surgery is still a controversial problem, because of possible fusion problems, significant neuropathic component of pain, and influence of anesthesia type. Aim of the study was to assess the efficacy of pain management after lumbar spine surgery considering characteristics of pain, type of anesthesia and analgesic regimen. Material and methods. 254 ASA I-II patients with degenerative lumbar spine disease were enrolled into prospective study. Patients were operated either under spinal anesthesia (SA) or total intravenous anesthesia (TIVA). In postoperative period patients got either standard pain management (SPM – paracetamol±morphine) or multimodal analgesia (MMA – paracetamol+parecoxib+pregabalin±morphine). Results. We revealed neuropathic pain in 53.9 % of patients, who were elected for lumbar spine surgery. VAS pain score in patients with neuropathic pain was higher, than in patients with nociceptive pain. Total intravenous anesthesia was associated with greater opioid consumption during the first postoperative day. Multimodal analgesia based on paracetamol, parecoxib and pregabalin allowed to decrease requirements for opioids, postoperative nausea and dizziness. Pregabalin used for evening premedication had equipotential anxiolytic effect as phenazepam without postoperative cognitive disturbances. Conclusions. Multimodal analgesia is opioid-sparing technique that allows to decrease complications. Spinal anesthesia is associated to a decreased opioid consumption in the 1st postoperative day.

scholarly journals INFLUENCE OF ANESTHESIA TYPE ON INTRAOCULAR PRESSURE DURING SPINE SURGERY IN PRONE POSITION

2020 ◽  
Vol 73 (1) ◽  
pp. 104-106
Author(s):  
Mykola V. Lyzohub ◽  
Marine A. Georgiyants ◽  
Kseniia I. Lyzohub ◽  
Juliia V. Volkova ◽  
Dmytro V. Dmytriiev ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Lumbar Spine ◽  
Spinal Anesthesia ◽  
Spine Surgery ◽  
Head Rotation ◽  
Lumbar Spine Surgery ◽  
Intravenous Anesthesia ◽  
Group I ◽  
Before And After ◽  
Spinal Segments

The aim was to examine intraocular pressure (IOP) during lumbar spine surgery in PP under general vs spinal anesthesia and to compare it with volunteers in PP. Materials and methods: We performed randomized prospective single institutional trial. Patients were operated in PP with fixation of 1-2 spinal segments. Patients of group I (n = 30) were operated under SA, group 2A (n = 25) – under TIVA (total intravenous anesthesia) with 45° head rotation (left eye was located lower, than right eye), group 2B (n=25) – under TIVA with no head rotation (both eyes were located on the same level). IOP was measured with Maklakov method before and after surgery. Volunteers (n = 20) were examined before and 90 minutes after lying in PP with 45° head rotation. Results: In all patients and volunteers after lying in PP, we found that IOP have increased. In SA patients and in TIVA patients with no head rotation there was no difference between eyes. The most significant raise of IOP was found in the dependent eye of IIA group patients: it was higher than in volunteers and I group patients (p < 0.01), and IIB group patients (p < 0.05). In SA patients there was no difference in IOP comparing to volunteers. Conclusions: IOP increased in PP in healthy people and patients under anesthesia (SA and TIVA). IOP in SA patients did not differ from volunteers. IOP increased superiorly in the dependent eye in TIVA patients.

scholarly journals Faster extubation time with more stable hemodynamics during extubation and shorter total surgical suite time after propofol-based total intravenous anesthesia compared with desflurane anesthesia in lengthy lumbar spine surgery

2016 ◽  
Vol 24 (2) ◽  
pp. 268-274 ◽  
Author(s):  
Chueng-He Lu ◽  
Zhi-Fu Wu ◽  
Bo-Feng Lin ◽  
Meei-Shyuan Lee ◽  
Chin Lin ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Length Of Stay ◽  
Operating Room ◽  
Spine Surgery ◽  
Total Intravenous Anesthesia ◽  
Lumbar Spine Surgery ◽  
Surgical Time ◽  
Intravenous Anesthesia ◽  
Extubation Time ◽  
Surgical Suite

OBJECT Anesthesia techniques can contribute to the reduction of anesthesia-controlled time and may therefore improve operating room efficiency. However, little is known about the difference in anesthesia-controlled time between propofol-based total intravenous anesthesia (TIVA) and desflurane (DES) anesthesia techniques for prolonged lumbar spine surgery under general anesthesia. METHODS A retrospective analysis was conducted using hospital databases to compare the anesthesia-controlled time of lengthy (surgical time > 180 minutes) lumbar spine surgery in patients receiving either TIVA via target-controlled infusion (TCI) with propofol/fentanyl or DES/fentanyl-based anesthesia, between January 2009 and December 2011. A variety of time intervals (surgical time, anesthesia time, extubation time, time in the operating room, postanesthesia care unit [PACU] length of stay, and total surgical suite time) comprising perioperative hemodynamic variables were compared between the 2 anesthesia techniques. RESULTS Data from 581 patients were included in the analysis; 307 patients received TIVA and 274 received DES anesthesia. The extubation time was faster (12.4 ± 5.3 vs 7.0 ± 4.5 minutes, p < 0.001), and the time in operating room and total surgical suite time was shorter in the TIVA group than in the DES group (326.5 ± 57.2 vs 338.4 ± 69.4 minutes, p = 0.025; and 402.6 ± 60.2 vs 414.4 ± 71.7 minutes, p = 0.033, respectively). However, there was no statistically significant difference in PACU length of stay between the groups. Heart rate and mean arterial blood pressure were more stable during extubation in the TIVA group than in the DES group. CONCLUSIONS Utilization of TIVA reduced the mean time to extubation and total surgical suite time by 5.4 minutes and 11.8 minutes, respectively, and produced more stable hemodynamics during extubation compared with the use of DES anesthesia in lengthy lumbar spine surgery.

Spinal anesthesia in contemporary and complex lumbar spine surgery: experience with 343 cases

2021 ◽  
pp. 1-8
Author(s):  
Jeffrey M. Breton ◽  
Calvin G. Ludwig ◽  
Michael J. Yang ◽  
T. Jayde Nail ◽  
Ron I. Riesenburger ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spinal Anesthesia ◽  
Spine Surgery ◽  
Outcome Data ◽  
Lumbar Spine Surgery ◽  
Class Iii ◽  
Instrumented Fusion ◽  
Fusion Procedure ◽  
Physical Status Classification ◽  
Wide Range

OBJECTIVE Spinal anesthesia (SA) is an alternative to general anesthesia (GA) for lumbar spine surgery, including complex instrumented fusion, although there are relatively few outcome data available. The authors discuss their experience using SA in a modern complex lumbar spine surgery practice to describe its utility and implementation. METHODS Data from patients receiving SA for lumbar spine surgery by one surgeon from March 2017 to December 2020 were collected via a retrospective chart review. Cases were divided into nonfusion and fusion procedure categories and analyzed for demographics and baseline medical status; pre-, intra-, and postoperative events; hospital course, including Acute Pain Service (APS) consults; and follow-up visit outcome data. RESULTS A total of 345 consecutive lumbar spine procedures were found, with 343 records complete for analysis, including 181 fusion and 162 nonfusion procedures and spinal levels from T11 through S1. The fusion group was significantly older (mean age 65.9 ± 12.4 vs 59.5 ± 15.4 years, p < 0.001) and had a significantly higher proportion of patients with American Society of Anesthesiologists (ASA) Physical Status Classification class III (p = 0.009) than the nonfusion group. There were no intraoperative conversions to GA, with infrequent need for a second dose of SA preoperatively (2.9%, 10/343) and rare preoperative conversion to GA (0.6%, 2/343) across fusion and nonfusion groups. Rates of complications during hospitalization were comparable to those seen in the literature. The APS was consulted for 2.9% (10/343) of procedures. An algorithm for the integration of SA into a lumbar spine surgery practice, from surgical and anesthetic perspectives, is also offered. CONCLUSIONS SA is a viable, safe, and effective option for lumbar spine surgery across a wide range of age and health statuses, particularly in older patients and those who want to avoid GA. The authors’ protocol, based in part on the largest set of data currently available describing complex instrumented fusion surgeries of the lumbar spine completed under SA, presents guidance and best practices to integrate SA into contemporary lumbar spine practices.

scholarly journals PAIN SYNDROME AND PAIN MANAGEMENT AFTER LUMBAR SPINE SURGERY

2019 ◽  
Vol 0 (3(88)) ◽  
pp. 23-26
Author(s):  
М. В. Лизогуб ◽  
М. А. Георгіянц ◽  
К. І. Лизогуб ◽  
А. О. Хмизов
Keyword(s):  
Lumbar Spine ◽  
Pain Management ◽  
Spine Surgery ◽  
Pain Syndrome ◽  
Lumbar Spine Surgery

scholarly journals Spinal anesthesia for lumbar spine surgery correlates with fewer total medications and less frequent use of vasoactive agents: A single center experience

PLoS ONE ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. e0217939 ◽  
Author(s):  
Hao Deng ◽  
Jean-Valery Coumans ◽  
Richard Anderson ◽  
Timothy T. Houle ◽  
Robert A. Peterfreund
Keyword(s):  
Lumbar Spine ◽  
Spinal Anesthesia ◽  
Spine Surgery ◽  
Lumbar Spine Surgery ◽  
Single Center ◽  
Vasoactive Agents ◽  
Single Center Experience ◽  
Frequent Use

Experiences of spinal anesthesia for previous lumbar spine surgery

2007 ◽  
Vol 24 (Supplement 39) ◽  
pp. 99
Author(s):  
S. Kim ◽  
S J. Lee ◽  
J H. Kim ◽  
Y S. Shin
Keyword(s):  
Lumbar Spine ◽  
Spinal Anesthesia ◽  
Spine Surgery ◽  
Lumbar Spine Surgery

scholarly journals 176 Efficiency of Spinal Anesthesia in Comparison to General Anesthesia in Lumbar Spine Surgery: A Retrospective Analysis of 544 Patients

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 245-246
Author(s):  
John Thomas Pierce ◽  
Prateek Agarwal ◽  
Paul J Marcotte ◽  
William Charles Welch
Keyword(s):  
Lumbar Spine ◽  
Blood Loss ◽  
Hospital Stay ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Spine Surgery ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Lumbar Spine Surgery ◽  
Anesthesia Time

Abstract INTRODUCTION Lumbar spine surgery can be successfully performed using various anesthetic techniques. Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia (SA) to general anesthesia (GA) in lumbar surgery. We sought to elucidate the more expedient anesthetic technique. METHODS Following IRB approval, a retrospective review of patients undergoing elective lumbar decompression surgery using GA or SA was performed. Demographic data known to influence perioperative morbidity was collected as well as safety and efficiency parameters. After controlling for patient and procedure characteristics, simple linear and multivariate regression analyses were performed to identify differences in operative blood loss, operative time, time from entering the OR until incision, time from bandage placement to exiting the OR, total anesthesia time, time in the post-anesthesia care unit (PACU), and length of hospital stay. RESULTS >544 consecutive lumbar laminectomy and discectomy surgeries were identified with 183 undergoing GA and 361 undergoing SA. The following times were all shorter for patients receiving SA than GA: operative time (97.4 vs. 151.8 min., P < 0.001), total anesthesia time (145.6 vs. 217.5 min., P < 0.001), time from entering the OR until incision (38.3 vs. 46.8 min., respectively, P < 0.001), time from bandage placement until exiting the OR (10.2 vs. 17.2 min., P < 0.001), and length of hospital stay (1.5 vs. 3.1 days, P < 0.001). The mean PACU length of stay was longer in the SA group than the GA group (178.0 vs. 116.5 min., P < 0.001). Estimated blood loss was less in the SA group than the GA group (62.1 vs. 176.3 mL, P < 0.001). CONCLUSION Spinal anesthesia may be the more expedient method of anesthesia in lumbar spinal surgery for all perioperative time points except for time in the PACU.

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