COMBINED CAUDAL EPIDURAL WITH GENERAL ANESTHESIA FOR LUMBAR DISCECTOMY

Document Type : Original Article

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Department of Anesthesia & Intensive Care and Pain Management Faculty of Medicine – Ain Shams University, Cairo, Egypt.

Abstract

Background: Lumbar Discectomy can be effectively performed using various anesthetic techniques. General anesthesia is more frequently used for these surgeries, though regional anesthesia when combined with general anesthesia is proven to be safe in few studies. Aim of the Work: To compare the intra operative and short term post-operative outcome variable in patients undergoing primary single level lumbar discectomy under combined caudal epidural with general anesthesia versus general anesthesia alone. Patients and Methods: This study included 100 patients aging 25 – 40 years old, admitted to operating room in Ain Shams University hospitals for single-level lumbar discectomy. The patients were divided into two groups of 50 each: Group A received general anesthesia, Group B, in addition to GA, received caudal epidural using 20 ml Bupivacaine 0.25% injected in the caudal region. Results: Intra operative HR, MAP, narcotic consumption, blood loss were lower in the Caudal Epidural with GA group. Post-operative 1st analgesia needed was less in the GA group. Post-operative VAS score and PONV were higher in the GA group when compared to combined caudal epidural with GA. There was no motor affection in both groups and sensory affection was with a median at T10 in the group receiving Caudal epidural with GA. Conclusion: Epidural caudal anesthesia can safely be combined with GA for single leveled lumbar discectomy. It reduces intraoperative tachycardia and hypertension, blood loss, intra-operative and postoperative IV analgesic requirements and PONV. 

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Ain Shams Medical Journal
Volume 73, Issue 3
September 2022
Pages 695-704

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