DOI: https://doi.org/10.22141/2224-0586.3.98.2019.165483

Influence of anesthesia type on blood loss during lumbar spine surgery

M.V. Lyzohub, M.A. Georgiyants, K.I. Lyzohub

Abstract


Background. Lumbar spine surgery may be performed under general (GA) or spinal (SA) anesthesia. One of the advantages of SA is thought to be reducing blood loss, but this question remains controversial. The aim of our study was to compare blood loss during lumbar spine surgery under spinal anesthesia or total intravenous anesthesia. Materials and me­thods. We examined 215 patients aged 18–70 years, ASA I–II with degenerative lumbar spine diseases, who were ope­rated with 1–2 segment fusion. In SA group (n = 110), we performed spinal anesthesia with 4 ml 0.5% bupivacaine. In GA group (n = 105), total intravenous anesthesia (propofol, fentanyl, atracurium in standard doses) was used. Mean arterial pressure (MAP) was strictly maintained at the level of 60–80 mmHg. Results. Urapidil for hemodynamics correction was used in 21.9 ± 4.0 % of GA patients and in 3.6 ± 1.8 % SA patients. MAP in SA group was significantly lower than in GA group. Nevertheless, we did not find any difference in blood loss between groups, but the surgery was significantly longer in GA group compared to SA group (128.5 ± 40.0 min vs 104.6 ± 26.3 min, р < 0.05). We also found strong correlation between surgery time and body mass index (r = 0.71, р < 0.05). Conclusions. Intraoperative blood loss does not depend on anesthesia type if we can maintain MAP at the level of 60–80 mmHg. SA provides better deliberate hypotension without pharmacological correction. Surgery time in GA group was significantly higher than in SA group. It depends on body mass index as well.


Keywords


lumbar spine; surgery; blood loss; anesthesia

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