A Novel Combined Anesthetic Technique to Improve the Surgical Working Conditions of Lumbar and Thoracolumbar Spine Surgery from a Spine Surgeon's Perspective: A Prospective Randomized Controlled Study

Subbiah Meenakshisundaram; Madhuvarshinee Kondusamy Manohar; Vinothan Rabindran John Santha; Poornima Vijayakumar; Ramanarayanan Ragupathy; Manikandan Bose; Suresh Palaniappan; James Vijay Anto; Yegumuthu Krishnan

doi:10.31616/asj.2022.0198

추천

검색

자료유형: 학술저널

저자정보: Subbiah Meenakshisundaram (Velammal Medical College Hospital and Research Institute Madurai India) Madhuvarshinee Kondusamy Manohar (Velammal Medical College Hospital and Research Institute Madurai India) Vinothan Rabindran John Santha (Velammal Medical College Hospital and Research Institute Madurai India) Poornima Vijayakumar (Velammal Medical College Hospital and Research Institute Madurai India) Ramanarayanan Ragupathy (Velammal Medical College Hospital and Research Institute Madurai India) Manikandan Bose (Velammal Medical College Hospital and Research Institute Madurai India) Suresh Palaniappan (Velammal Medical College Hospital and Research Institute Madurai India) James Vijay Anto (Velammal Medical College Hospital and Research Institute Madurai India) Yegumuthu Krishnan (Department of Pathology Velammal Medical College Hospital and Research Institute Madurai India)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.17 No.2

발행연도: 2023.4

수록면: 285 - 292 (8page)

DOI: 10.31616/asj.2022.0198

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

초록· 키워드

오류제보하기

Study Design: Prospective randomized controlled study.Purpose: This study aimed to assess the effects of a different combination of anesthetic techniques in lumbar and thoracolumbar spinal surgeries in terms of muscle relaxation and surgical field in addition to hemodynamic parameters.Overview of Literature: Adequate relaxation of the erector spinae muscle and good surgical fields are preferred in lumbar spine surgeries. The effects of anesthetic techniques on these parameters have not been evaluated from a surgeon’s perspective to date. We propose a novel combined anesthetic technique that improves the working conditions from a surgeon’s perspective as we hypothesize that combining general anesthesia (GA) with regional anesthesia (RA) might provide benefits for both techniques.Methods: A prospective randomized study of 76 patients who underwent lumbar and thoracolumbar surgeries was conducted by randomly allocating patients into three anesthetic groups: GA alone, GA with spinal anesthesia (SA), and GA with erector spinae plane block (ESPB) by the allocation concealment method to avoid selection bias. The working conditions were assessed by the same operating surgeon who was blinded by the type of anesthesia to eliminate the assessment bias. Muscle relaxation and surgical field were compared among the three groups along with other hemodynamic parameters to identify any significant differences.Results: Significantly better muscle relaxation, surgeon satisfaction, postoperative analgesia, and blood pressure (BP) were observed in the GA+RA when compared to GA alone (p <0.01), whereas no difference was observed between the GA+SA and GA+ESPB groups (p >0.05). Complications were only observed in the GA+SA group (19%).Conclusions: The study results suggest that the addition of RA to GA may provide better working conditions and surgeon’s satisfaction by improving relaxation of the erector spinae in addition to decreasing the BP and postoperative pain in contrast to the use of GA alone. The combined GA and ESPB techniques may be a viable anesthetic alternative to provide better working conditions for surgeons.

#Lumbar vertebrae #Muscle relaxation #Nerve block #Paraspinal muscles #Spine

참고문헌 (0)

참고문헌 신청

참고문헌이 DBpia에서 서비스 중이라면, [참고문헌 신청]을 통해 등록해보세요

함께 읽어보면 좋을 논문

논문 유사도에 따라 DBpia 가 추천하는 논문입니다. 함께 보면 좋을 연관 논문을 확인해보세요!