Effect of combining epidural with general anesthesia on recovery after spine surgery: randomized controlled study

ABSTRACT

Background: Fast track techniques have been applied to reduce surgical stress response and to provide effective perioperative analgesia, thereby improving patient''''''''s recovery and reducing postoperative morbidity. The present study was undertaken to assess the effect of using combined general/epidural anesthesia (CGEA) on early recovery after lumbar spine surgeries. Subjects and Methods: The current prospective randomized clinical study had included a total of 40 patients who underwent elective one or two level laminectomy/discectomy. Patients were randomized and divided into two groups; general anesthesia (GA) group (group I) and combined general/epidural anesthesia group (CGEA) (group II). Patient characteristics, anesthesia time, surgical time, heart rate, mean arterial pressure (MAP), anesthetic / analgesic requirements, the occurrence of intraoperative bradycardia and/or hypotension, time to extubation, time to post anesthesia care unit (PACU) discharge and duration of PACU stay were recorded and considered for analysis. Results: It was observed that CGEA was significantly associated with reduction of intraoperative anesthetics / analgesic requirements, shorter time to extubation, time for PACU discharge and duration of PACU stay but on the expense of higher incidence of intraoperative hypotension. Conclusion: This study proved that CGEA seems to be an effective fast track anesthetic protocol in patients undergoing elective lumbar spine surgeries