Journal of Pain Research (Jul 2021)
Percutaneous Endoscopic Interlaminar Discectomy with Modified Sensation-Motion Separation Anesthesia for Beginning Surgeons in the Treatment of L5-S1 Disc Herniation
Abstract
Meng Kong,1 Changtong Gao,2 Wenbin Cong,3 Guanghui Li,1 Chuanli Zhou,1 Xuexiao Ma1 1Department of Spine Surgery, Affiliated Hospital of Qingdao University, Qing’dao, Shandong Province, 266000, People’s Republic of China; 2Minimally Invasive Interventional Therapy Center, Qingdao Municipal Hospital, Qing’dao, Shandong Province, 266000, People’s Republic of China; 3Department of Radiology, Affiliated Hospital of Qingdao University, Qing’dao, Shandong Province, 266000, People’s Republic of ChinaCorrespondence: Xuexiao Ma; Chuanli ZhouDepartment of Spine Surgery, Affiliated Hospital of Qingdao University, No. 59, Hai Er Road, Qing’dao, Shandong Province, 266000, People’s Republic of ChinaTel +86 186 61807895Email [email protected]; [email protected]: To compare the clinical effects of local anesthesia (LA), general anesthesia (GA) and modified sensation-motion separation anesthesia (MA) in percutaneous endoscopic interlaminar discectomy (PEID) in the treatment of L5/S1 lumbar disc herniation (LDH) for the purpose of guiding junior surgeons.Methods: Eighty-four patients with L5/S1 LDH underwent PEID using three anesthesia methods. Patients in the LA (26), GA (29) and MA (29) groups received a follow-up examination retrospectively. The general parameters, preparation and anesthesia duration, operative duration, recovery time, incidence of complications, ambulation time, length of hospital stay, incidence of severe complications, and reoperation rate were compared, and clinical outcomes were analyzed using a visual analog scale (VAS), the Oswestry Disability Index (ODI), and the Short-Form Health Survey 36 (SF-36).Results: MA demonstrated obvious advantages over the other two methods with respect to operative duration and resulted in a better intraoperative experience than LA. The patients in the MA group required less time in bed postoperatively and shorter hospital stays than those in the GA group. The mean postoperative VAS, ODI and SF-36 scores were significantly better than the preoperative scores in all groups (P 0.05). Three cases (3/29) of nervous disorder occurred in the GA group. Two patients (one in the GA group (1/29) and one in the LA (1/26) group) underwent revision surgery, with a total recurrence rate of 2.4% (2/84).Conclusion: Due to its high safety and good tolerance by patients, MA is a suitable method for spinal surgeons who are inexperienced with PEID in the treatment of L5/S1 disc herniation.Keywords: anesthesia, LDH, sensation-motion separation, PEID
