Epidural compared to General Anesthesia for Lumbar Spine Surgery

Lumbar spinal cord surgery can be performed safely under general anesthesia
(GA) or epidural anesthesia (EA). GA is mostly preferred because of greater
patient and physician acceptance and the ability to perform operations of
longer duration in the prone position with a secured airway. It is demonstrated
that regional anesthesia reduces blood loss (1). During EA the awake patient
can self-position to avoid nerve injury of the brachial plexus and pressure
necrosis especially to the face. In addition, the perioperative feed-back of
the patient allows precise localisation of the involved nerve root to the
surgeon and guarding against injuries. Finally, this technique provides
excellent long lasting postoperative analgesia. Proposed disadvantages of EA
for this surgery are the inability to immediately assess the neurological
function, and affected bladder function.
The Sint Lucas Andreas Hospital has performed EA for lumbar spine surgery
successfully since the early eighteis. Although the broad experience this has
never been evaluated for perioperative blood loss, time of discharge from the
recovery unit and the common postoperative problems such as pain, analgesic
need, nausea, and vomiting.

Greenbarg et al. Epidural anesthesia for lumbar spine surgery. J Spinal Disord.
1988;1(2):139-43

To assess whether there is less peri-operative pain and a faster post operative
recovery.

We designed a prospective randomised trail to compare GA and EA for lumbar
spinal cord surgery.

Either general anesthesia (control group) or epidural anesthesia (study group).

not applicable