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Journal of Ideas in Health

Articles
DOI: 10.47108/jidhealth.Vol8.Iss2.412
Submitted: 2025-03-11
Published: 2025-04-30

Assessing the effectiveness of spinal compared to general anesthesia in scheduled minimally invasive lumbar spine surgeries in a tertiary care hospital in Gujarat, India

Department of Neurosurgery, Parul Institute of Medical Sciences and Research, Parul University Vadodara, India
Parul Institute of Medical Sciences and Research, Parul University, Vadodara, Gujarat, India
Parul Institute of Medical Sciences and Research, Parul University, Vadodara, Gujarat, India
Jivraj Mehta hospital, Ahmedabad, Gujarat, India
Spinal Anesthesia, Minimally Invasive Spine Surgery, Patient Satisfaction, Regional Anaesthesia, Prone Position, Hemodynamic Stability, India

Abstract

Background: Minimally invasive spine surgery (MIS) is increasingly preferred over traditional open surgery due to its advantages. Anesthesia choice plays a key role in surgical outcomes. This study compares spinal anesthesia (SA) and general anesthesia (GA) in patients undergoing scheduled MIS for lumbar spine conditions.

Methods: This prospective randomized study was conducted in Parul Sevashram Hospital, Parul University, Vadodara, Gujarat, between May 2024 and October 2024. The study included 34 ASA-1 and ASA-2 patients scheduled for one—or two-level MIS, divided into two groups: Group G (GA) and Group S (SA). Preoperative evaluation included demographics, lab tests, and imaging. Intraoperative monitoring covered heart rate, mean arterial pressure, and oxygen saturation. Postoperative assessments included blood loss, satisfaction scores, and complications.

Results: Spinal anesthesia (SA) showed better hemodynamic stability, reduced blood loss (67.5±19.8 ml in Group S vs 73.2±14.9 ml in Group G), and higher satisfaction scores. Surgery duration was shorter in the SA group (89.9±8.2 min in Group S vs 94±7.2 min in Group G), with fewer complications. PACU stay was significantly lower in Group S (134±17.2 min) compared to Group G (175±20.4 min). Postoperative analgesic requirement (Inj Butorphanol) was also less in Group S (5 mg vs 14 mg IV).

Conclusion: Spinal anesthesia is a safe and effective alternative to general anesthesia for MIS, offering better patient outcomes and satisfaction. This study supports the broader use of spinal anesthesia in suitable candidates to improve perioperative care.



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References

  1. Yadav RI, Long L, Yanming C. Comparison of the effectiveness and outcome of microendoscopic and open discectomy in patients suffering from lumbar disc herniation. Medicine (Baltimore) [Internet]. 2019 Dec 1 [cited 2025 Apr 29];98(50):e16627. Available from: https://doi.org/10.1097/md.0000000000016627
  2. Peng H, Tang G, Zhuang X, Lu S, Bai Y, Xu L. Minimally invasive spine surgery decreases postoperative pain and inflammation for patients with lumbar spinal stenosis. Exp Ther Med [Internet]. 2019 Aug 20 [cited 2025 Apr 29]; Available from: https://doi.org/10.3892/etm.2019.7917
  3. Meng T, Zhong Z, Meng L. Impact of spinal anesthesia vs. general anesthesia on peri-operative outcome in lumbar spine surgery: a systematic review and meta-analysis of randomised, controlled trials. Anaesthesia [Internet]. 2016 Oct 22 [cited 2025 Apr 29];72(3):391–401. Available from: https://doi.org/10.1111/anae.13702
  4. Mahajan NHM, Patel NSJ. To compare the efficacy of intrathecal 0.75% heavy ropivacaine and 0.5% heavy bupivacaine for lower abdominal and lower limb surgery. Asian J Med Sci [Internet]. 2023 Sep 1 [cited 2025 Apr 29];14(9):58–63. Available from: https://doi.org/10.3126/ajms.v14i9.53793
  5. De Biase G, Gruenbaum SE, West JL, Chen S, Bojaxhi E, Kryzanski J, et al. Spinal versus general anesthesia for minimally invasive transforaminal lumbar interbody fusion: implications on operating room time, pain, and ambulation. Neurosurg Focus [Internet]. 2021 Dec 1 [cited 2025 Apr 29];51(6):E3. Available from: https://doi.org/10.3171/2021.9.focus21265
  6. Deng H, Coumans JV, Anderson R, Houle TT, Peterfreund RA. Spinal anesthesia for lumbar spine surgery correlates with fewer total medications and less frequent use of vasoactive agents: A single center experience. PLoS One [Internet]. 2019 Jun 13 [cited 2025 Apr 29];14(6):e0217939. Available from: https://doi.org/10.1371/journal.pone.0217939
  7. Donmez T, Erdem VM, Uzman S, Yildirim D, Avaroglu H, Ferahman S, et al. Laparoscopic cholecystectomy under spinal-epidural anesthesia vs. general anaesthesia: a prospective randomised study. Ann Surg Treat Res [Internet]. 2017 Jan 1 [cited 2025 Apr 29];92(3):136. Available from: https://doi.org/10.4174/astr.2017.92.3.136
  8. Lee JK, Park JH, Hyun SJ, Hodel D, Hausmann ON. Regional anesthesia for lumbar spine surgery: Can it be a standard in the future? Neurospine [Internet]. 2021 Dec 29 [cited 2025 Apr 29];18(4):733–40. Available from: https://doi.org/10.14245/ns.2142584.292
  9. Mehta N, Dar M, Sharma S, Mehta K. Thoracic combined spinal epidural anesthesia for laparoscopic cholecystectomy: A feasibility study. J Anaesthesiol Clin Pharmacol [Internet]. 2016 Jan 1 [cited 2025 Apr 29];32(2):224. Available from: https://doi.org/10.4103/0970-9185.173384
  10. Singh RK, Saini AM, Goel N, Bisht D, Seth A. Major laparoscopic surgery under regional anesthesia: A prospective feasibility study. Med J Armed Forces India [Internet]. 2015 Feb 11 [cited 2025 Apr 29];71(2):126–31. Available from: https://doi.org/10.1016/j.mjafi.2014.12.010
  11. Salman N. Endovascular repair of dissecting abdominal aortic aneurism under spinal anesthesia in a patient with pulmonary embolus. Turk Gogus Kalp Damar Cerrahisi Derg [Internet]. 2011 Oct 18 [cited 2025 Apr 29];19(4):645–8. Available from: https://doi.org/10.5606/tgkdc.dergisi.2011.105
  12. Dashtbani M, Dori MM, Hassani M, Omidi-Kashani F. A Survey on the Short-term Outcome of Microlumbar Discectomy with General versus Spinal Anesthesia. Clin Orthop Surg [Internet]. 2019 Jan 1 [cited 2025 Apr 29];11(4):422. Available from: https://doi.org/10.4055/cios.2019.11.4.422
  13. Perez-Roman RJ, Govindarajan V, Bryant JP, Wang MY. Spinal anesthesia in awake surgical procedures of the lumbar spine: a systematic review and meta-analysis of 3709 patients. Neurosurg Focus [Internet]. 2021 Dec 1 [cited 2025 Apr 29];51(6):E7. Available from: https://doi.org/10.3171/2021.9.focus21464
  14. Rangnekar A, Praveen GV, Chugh A, Raut S, Kundnani V. Efficiency of Spinal Anesthesia versus General Anesthesia for Minimal Invasive Single Level Transforaminal Lumbar Interbody Fusion: A Retrospective Analysis of 178 Patients. J Minim Invasive Spine Surg Tech [Internet]. 2022 Jan 18 [cited 2025 Apr 29];7(1):107–12. Available from: https://doi.org/10.21182/jmisst.2021.00241
  15. Kanter M, Hernandez NS, Olmos M, Karimi H, Riesenburger RI, Kryzanski JT. Intraoperative triggered electromyography for pedicle screw placement under spinal anesthesia: a preliminary report. Oper Neurosurg (Hagerstown) [Internet]. 2023 Feb 3 [cited 2025 Apr 29]; Available from: https://doi.org/10.1227/ons.0000000000000640
  16. Yuzkat N, Soyoral L, Cegin MB, Ozkan B, Goktas U. The role of surgical diagnosis in the choice of anesthetic technique. Electron J Gen Med [Internet]. 2016 Apr 6 [cited 2025 Apr 29];13(2). Available from: https://doi.org/10.15197/ejgm.1458
  17. Zorofchi BH, Jahan E, Nassiri S, Najmodin A, Saffarieh E. Comparing spinal and general anesthesia in terms of postoperative pain in patients undergoing hysterectomy. J Obstet Gynecol Cancer Res [Internet]. 2018 Jun 1 [cited 2025 Apr 29];3(2):73–7. Available from: https://doi.org/10.30699/jogcr.3.2.73
  18. Morris MT, Morris J, Wallace C, Cho W, Sharan A, Abouelrigal M, et al. An analysis of the cost-effectiveness of spinal versus general anesthesia for lumbar spine surgery in various hospital settings. Glob Spine J [Internet]. 2018 Aug 21 [cited 2025 Apr 29];9(4):368–74. Available from: https://doi.org/10.1177/2192568218795867
  19. Kuo Y. Comparative effectiveness of spinal versus general anesthesia for lumbar spine surgery: A systematic review. J Clin Anesth [Internet]. 2018 Jul [cited 2025 Apr 29];48:1–8. Available from: https://doi.org/10.1016/j.jclinane.2018.07.001
  20. Lee J. Spinal anesthesia versus general anesthesia for lumbar spine surgery: A meta-analysis. Anesth Analg [Internet]. 2020 Apr [cited 2025 Apr 29];130(4):1019–28. Available from: https://doi.org/10.1213/ANE.0000000000000495
  21. Kwon W. The effects of spinal anesthesia on hemodynamic stability during lumbar spine surgery. Korean J Anesthesiol [Internet]. 2019 Oct [cited 2025 Apr 29];72(5):451–9. Available from: https://doi.org/10.4097/kja.19033
  22. Ahn H. The impact of anesthesia technique on postoperative outcomes in patients undergoing lumbar spine surgery. Neurosurgery [Internet]. 2017 Apr [cited 2025 Apr 29];80(4):646–53. Available from: https://doi.org/10.1093/neuros/nyx001
  23. Meng Y. Impact of spinal anaesthesia vs. general anaesthesia on peri-operative outcome in lumbar spine surgery: A systematic review and meta-analysis. Anaesthesia [Internet]. 2016 Sep [cited 2025 Apr 29];71(9):1047–56. Available from: https://doi.org/10.1111/anae.13697
  24. Zhang Y. Effectiveness of spinal anesthesia in reducing postoperative complications in lumbar spine surgery: A systematic review. Eur Spine J [Internet]. 2019 Jan [cited 2025 Apr 29];28(1):34–42. Available from: https://doi.org/10.1007/s00586-018-5757-6
  25. Hwang J. Postoperative nausea and vomiting: A comparison of spinal and general anesthesia. Br J Anaesth [Internet]. 2018 Aug [cited 2025 Apr 29];121(2):368–75. Available from: https://doi.org/10.1016/j.bja.2018.04.025
  26. Lee S. The incidence of postoperative nausea and vomiting in patients undergoing spinal anesthesia: A systematic review. Anesth Analg [Internet]. 2017 Oct [cited 2025 Apr 29];125(4):1312–9. Available from: https://doi.org/10.1213/ANE.0000000000001935


How to Cite

1.
Patel V, Jain A, Pandya J, Pancholi S. Assessing the effectiveness of spinal compared to general anesthesia in scheduled minimally invasive lumbar spine surgeries in a tertiary care hospital in Gujarat, India. J Ideas Health [Internet]. 2025 Apr. 30 [cited 2025 Sep. 22];8(2):1285-91. Available from: https://jidhealth.com/index.php/jidhealth/article/view/412

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