Impact of spinal anaesthesia vs. general anaesthesia on peri-operative outcome in lumbar spine surgery

Meng, T. et al. (2017) Anaesthesia. 72(3) pp. 391-401

Introduction: The authors systematically reviewed the comparative evidence for the use of spinal anaesthesia versus general anaesthesia for lumbar spinal surgery.

Results: Eight studies with a total of 625 patients were included. These were considered to be at high risk of bias. Compared with general anaesthesia, the risk ratio (95% confidence interval [CI]) with spinal anaesthesia for intraoperative hypertension was 0.31 (0.15 to 0.64), I2 = 0% (p=0.002); for intraoperative tachycardia 0.51 (0.30 to 0.84), I2 = 0% (p=0.009); for analgesic requirement in the post-anaesthesia care unit 0.32 (0.24 to 0.43), I2 = 0% (p<0.0001); and for nausea/vomiting within 24 hours postoperatively 0.29 (0.18 to 0.46), I2 = 12% (p<0.00001). The standardised mean difference (95% CI) for hospital stay was -1.15 (–1.98 to –0.31), I2 = 89% (p=0.007). There was no evidence of a difference in intraoperative hypotension and bradycardia, blood loss, surgical time and analgesic requirement within 24 hours postoperatively or nausea/vomiting in the post-anaesthesia care unit.

Conclusions: The authors conclude that spinal anaesthesia appears to offer advantages over general anaesthesia for lumbar spine surgery.

Read the full abstract here

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