Soyarslan Özgün DEMİRKOL, Onur ÖZLÜ, Gülten ÜTEBEY, Uyğur ER

Lomber omurga cerrahisinde spinal anestezi ve total intravenöz anestezinin karşılaştırılması

Amaç: Lomber omurga cerrahisinde spinal anestezi ve total intravenöz anestezi (TIVA) tekniklerinin operasyon süresi, kanama miktarı, hemodinamik özellikler, postoperatif ağrıya etkilerini değerlendirmektir. Yöntem: Lomber diskektomi ve/veya laminektomi operasyonu planlanan, ASA I-II risk grubu 60 hasta iki gruba ayrıldı. Grup S’de (n=30), 15 mg bupivakain ile spinal anestezi uygulamasından sonra duyu bloğu T6-10 seviyesine ulaşınca, yüzüstü pozisyon verildi. Grup T’de (n=30), propofol ve remifentanil ile TIVA gerçekleştirildi. Anestezi, operasyon süreleri, kanama miktarı, perioperatif ortalama kan basıncı (OKB), kalp hızı (KAH), postoperatif ağrı düzeyleri kaydedildi. Bulgular: Operasyona başlama ve operasyon süreleri gruplarda benzerdi (p>0,05). Grup S’de operasyon anında kanama miktarı, operasyon odasında kalış süresi (94,1±20,8 dk vs 108,0±23,2 dk) daha az izlendi (p

Comparing total intravenous anesthesia and spinal anesthesia in Lumbar spinal surgery

Objective: We compared, total intravenous anesthesia (TIVA) and spinal anesthesia in lumbar disk surgery, with respect to surgical times, blood loss, hemodynamic effects and postoperative pain. Methods: Sixty ASA I-II patients, planned for lumbar disk surgery, were allocated into two groups. In Group S (n=30), spinal anesthesia was performed with 15 mg bupivacaine. When the T6-10 sensory level was achieved, the patient was turned to the prone position. In Group T (n=30), propofol and remifentanil infusions were administered. Anesthesia and surgical times, blood loss, perioperative mean arterial pressure (MAP), heart rate (HR) and postoperative pain scores were recorded. Results: Surgical onset and surgical time were similar (p>0.05). Blood loss and duration in the operating room (94.1±20.8 vs. 108.0±23.2 min) was less in Group S (p<0.05). MAP at 3rd min of anesthesia and HR at the 30, 40 and 50 min of surgery was less in Group T (p<0.002). Postoperative pain scores were higher in Group T (p<0.004). Patient and surgeon satisfaction scores were comparable (p>0.05). Conclusion: Spinal anesthesia has advantages over TIVA with respect to reduced amount of blood loss, reduced total stay in the operation room and better postoperative analgesia for lumbar disk surgery.

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