The Advantages of Epidural Anesthesia Using Alkalinized Articaine Over General Anesthesia in Lumbar Herniated Disc Surgery

Guldeniz Argun, Neslihan Erdogan, Suat Canbay, Mesut Misirlioglu, Murat Arikan

Abstract


Aim: In this study, we used alkalinized articaine that has no published use for epidural anesthesia (EA) and compared its intraoperative and postoperative evaluation of general anesthesia (GA) in lumbar disc herniation surgery. Our goal was to obtain a less invasive and safer anesthesia for lumbar disc surgery by EA using a more potent local anesthetic that was alkalinized.

 

Methods: Fifty patients with American Society of Anesthesiologist values 1–3 physical status were divided into two groups randomly, the GA and EA groups. EA was administered in a 22 mL solution containing fentanyl 0.1 mg, articaine 5 mg kg−1 + 8.4% NaHCO3 2 mL + 0.9% NaCl into the epidural space. GA was administered classically. Hemodynamic changes, hemorrhage, blockage levels, and total surgery time, side effects, hospitalization time, patient/surgeon satisfaction levels, and analgesic requirement were recorded for all patients.

 

Results: Surgery start time and total surgery time was shorter in the EA group. Intraoperative blood loss was significantly lower in the EA group. Postoperative pain starting time was longer in the EA group. (148.26 / 65.30 min) (p˂0.05). Fentanyl consumption within the first 24 h was higher in the GA group (561/173 µgr). The level of patient and surgeon satisfaction with the anesthesia were higher in the EA group (p<0.05). The discharge time was also shorter in the EA group (1.76/3.16 days, p<0.05).

 

Conclusion: The EA technique with alkalinized articaine is superior to GA for patient's satisfaction and causality of medical comorbidities in lumbar disc surgeries.

 


Keywords


: Alkalinization; articaine; epidural anesthesia; spinal disc surgery; general anesthesiology

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