Comparison of Intra-Operative and Postoperative Outcomes after General and Spinal Anesthesia in Spine Surgeries

Abstract

Background: Operations on the spine can be performed under conditions of both general anesthesia (GA) and spinal anesthesia (SA). Some authors suggested that reduced blood loss is one of the beneficial characteristics of spinal anesthesia . However, this issue still under debate.

Objective: To compare the volume of blood loss during surgeries involving lumbar spine using either Spinal or general anesthesia.

Patients and Methods: This was a comparative observational prospective study included 60 our staei patients aged between 18-70 years. All of them met the American Society of Anesthesiologists (ASA) classification I and II who had degenerative diseases of the spine and  underwent planned surgical interventions with transpedicular stabilization of one or two segments.  Patients were assigned into two groups accotding to the type of anesthesia with 30 patients in each group; first group who received general anesthesia, namely (GA group) and the second group received spinal anesthesia (SA group). A strict condition in this study was maintenance of the mean arterial pressure at 60-80 mmHg. Statistical analysis performed using the statistical package for social sciences (SPSS) cersion 27 and appropriate statistical tests were applied accordingly at a level of significance of ≤ 0.05. 

Results: The study included two groups with 30 patients in each group. Both studied groups were matched for their age, gender and ASA classification,

Duration of surgery was not significantly different between both groups, (P>0.05). Blood loss volume was significantly larger in  GA group, (P<0.05), Heart rate was significantly more changed in GA group compared to SA group, the mean change was 7 ± 2 and 3 ± 1, respectively, (P < 0.05). No significant difference between both groups in each of complications and postoperative nausea and vomiting (PONV). Both surgeon and patient were highly satisfied with SA than GA,( P<0.05). Despite the higher proportion of patients needed analgesics in SA at  PACU but after 24 hours none of the SA group needed further analgesia compared to 8 in GA group  with statistical significance, (P<0.05).

Conclusions: Volume of blood loss was not affected by the type of anesthesia when the mean arterial blood pressure maintained at a level of 60-80 mmHg. Spinal anesthesia has an advantage of better control for hypotension without using additional therapeutics. Total time of surgery was longer in GA than SA group and it was directly correlated with body mass index of the patient.