Influence of anesthesia type on blood loss during lumbar spine surgery


  • M.V. Lyzohub SI “State Institution “Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine
  • M.A. Georgiyants Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
  • K.I. Lyzohub Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine



lumbar spine, surgery, blood loss, anesthesia


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.


Download data is not yet available.


Martin B., Mirza S., Spina N., Spiker W., Lawrence B., Brodke D. Trends in Lumbar Fusion Procedure Rates and Associated Hospital Costs for Degenerative Spinal Diseases in the United States, 2004–2015 // Spine. — 2018. — 4(5). — Р. 369-376. doi: 10.1097/BRS.0000000000002822.

Lessing N., Edwards II Ch., Brown Ch., Ledford E., Dean C., Lin Ch., Edwards Ch. Spinal Anesthesia in Elderly Patients Undergoing Lumbar Spine Surgery // Orthopedics. — 2017. — 40(2). — Р. 317-322;

Attari M., Mirhosseini S., Honarmand A., Safavic M. Spinal anesthesia versus general anesthesia for elective lumbar spine surgery: A randomized clinical trial // J. Res. Med. Sci. — 2011. — 16(4). — Р. 524-529. PMCID: PMC3214358PMID: 22091269.

Walcott B.P., Khanna A., Yanamadala V., Coumans J.V., Peterfreund R.A. Cost analysis of spinal and general anesthesia for the surgical treatment of lumbar spondylosis // J. Clin. Neurosci. — 2015. — 22. — Р. 539-543.

Метод определения объема и степени острой кровопотери / Тимербулатов Ш.В., Фаязов Р.Р., Смыр Р.А., Гатауллина Э.З., Шакиров Р.Ф., Идрисов Т.С., Исмагилова Ю.М. // Клиническая и экспериментальная хирургия. — 2012. — Т. 5, № 3. — C. 49-54.

Montes-Casillas Y., Zazueta-Medina F. Determination of postoperative hemoglobin levels and their correlation with the weight of the transoperative textiles // Gac. Med. Mex. — 2016. — 152. — Р. 604-607.

Soghomonyan S., Stoicea N., Sandhu G., Pasternak J., Bergese S. The Role of Permissive and Induced Hypotension in Current Neuroanesthesia Practice // Front. Surg. — 2017. — 4. — Р. 1-10. doi: 10.3389/fsurg.2017.00001.

Bible J., Mirza M., Knaub M. Blood-loss Management in Spine Surgery // Journal of the American Academy of Orthopaedic Surgeons. — 2018. — 26(2). — Р. 35-44. doi: 10.5435/jaaos-d-16-00184.

Anvari Z., Afshar-Fereydouniyan N., Imani F., Sakhaei M., Alijani B., Mohseni M. Effect of Clonidine Premedication on Blood Loss in Spine Surgery // Anesthesiology and Pain Medicine. — 2012. — 1(4). — Р. 252-256.

Sadrolsadat S.H., Mahdavi A.R., Moharari R.S. et al. A prospective randomized trial comparing the technique of spinal and general anesthesia for lumbar disk surgery: a study of 100 cases // Surg. Neurol. — 2009. — 71. — Р. 60-65.

Zorrilla-Vaca A., Healy R., Mirski M. A Comparison of Regional Versus General Anesthesia for Lumbar Spine Surgery // Journal of Neurosurgical Anesthesiology. — 2017. — 29(4). — Р. 415-425. doi: 10.1097/ana.0000000000000362.

Meng T., Zhong Z., Meng L. Impact of spinal anaesthesia vs. general anaesthesia on peri-operative outcome in lumbar spine surgery: a systematic review and meta-analysis of randomised, controlled trials // Anaesthesia. — 2016. — 72(3). — Р. 391-401. doi: 10.1111/anae.13702.

Albertin A., La Colla L., Gandolfi A. et al. Greater peripheral blood flow but less bleeding with propofol versus sevoflurane during spine surgery: a possible physiologic model? // Spine (Phila Pa 1976). — 2008. — 33. — Р. 2017-2022.

Willner D., Spennati V., Stohl S., Tosti G., Aloisio S., Bilotta F. Spine Surgery and Blood Loss: Systematic Review of Clinical Evidence // Anesthesia & Analgesia. — 2016. — 123(5). — Р. 1307-1315. doi: 10.1213/ANE.0000000000001485.

Mathai K., Kang J., Donaldson W., Lee J., Buffington C. Prediction of blood loss during surgery on the lumbar spine with the patient supported prone on the Jackson table // The Spine Journal. — 2012. — 12(12). — Р. 1103-1110. doi: 10.1016/j.spinee.2012.10.027.

Villavicencio A., Lee Nelson E., Rajpal S., Vivek N., Burneikiene S. The impact of BMI on operating room time, blood loss, and hospital stay in patients undergoing spinal fusion // Clin. Neurol. Neurosurg. — 2019. — 11(179). — Р. 19-22. doi: 10.1016/j.clineuro.2019.02.012.



How to Cite

Lyzohub, M., Georgiyants, M., & Lyzohub, K. (2021). Influence of anesthesia type on blood loss during lumbar spine surgery. EMERGENCY MEDICINE, (3.98), 80–84.



Original Researches

Most read articles by the same author(s)

1 2 > >>