The Effects of Epidural Anesthesia in Elderly Patients during Single-Level Lumbar Microdiscectomy

ABSTRACT

OBJECTIVE: To analyze the effect of epidural anesthesia in elderly patients with single-level lumbar discectomy. METHODS: Medical records of 28 patients aged between 60 and 90 years who had undergone single-level lumbar microdiscectomy by two surgeons from January 2004 to December 2008 were retrospectively reviewed. Patients were divided into 2 groups Group I was comprised of patients with lumbar discectomy under epidural anesthesia and Group II was comprised of patients with lumbar discectomy under general anesthesia. Factors taken into account when comparing the effects of epidural and general anesthesia were surgical time, anesthetic time, starting time of ambulation after surgery, hospital stay, postoperative headache, nausea, vomiting, urinary difficulty, back pain and patient satisfaction. The score on the visual analogue scale(VAS) for back pain was measured after surgery. RESULTS: 15 patients(Group I) underwent discectomy under epidural anesthesia. The mean age of patients in Group I and II were 65+/-6.1 years and 67+/-6.7 years, respectively. 19 patients had underlying co-morbidities, such as cardiovascular, pulmonary, cerebrovascular diseases and cancer. Demographically, there was no statistical diffe- rence between the two groups. Surgical time, anesthetic time, starting time of ambulation after surgery and hospital stay were longer in patients in Group II. The incidences of urinary difficulty and VAS score for back pain were significantly lower in Group I. The incidences of headache, nausea and vomiting and patient satisfaction were not different between Group I and II. CONCLUSION: Epidural anesthesia was as efficacious and as safe as general anesthesia. Elderly patients who need to undergo single-level lumbar discectomy could be offered epidural anesthesia.