Our Summary

This research paper explores the differences between using general anaesthesia (GA) and spinal anaesthesia (SA) for a specific type of back surgery called lumbar laminectomy. The researchers compared various factors such as heart rate, blood pressure, blood loss during surgery, length of surgery, recovery time, pain level, need for pain medication, and post-surgery side effects like nausea and urinary issues.

After reviewing data from eleven different studies, the researchers found that, in most cases, spinal anaesthesia had better outcomes than general anaesthesia. Patients who had spinal anaesthesia showed more stable heart rate and blood pressure during surgery, had better pain control, used less pain medication, and also had fewer side effects like nausea after surgery.

Based on these findings, the researchers suggest that more consideration should be given to using spinal anaesthesia instead of general anaesthesia for this type of back surgery.

FAQs

  1. What type of anesthesia did the research find to be more effective for lumbar laminectomy?
  2. What are the benefits of using spinal anaesthesia over general anaesthesia for lumbar laminectomy according to the research?
  3. What factors did the researchers use to compare the effectiveness of spinal anaesthesia and general anaesthesia in lumbar laminectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal laminectomy is that they may have better outcomes if they opt for spinal anaesthesia instead of general anaesthesia. Spinal anaesthesia can lead to more stable heart rate and blood pressure during surgery, better pain control, less need for pain medication, and fewer post-surgery side effects like nausea. It may be worth discussing with your healthcare provider the option of using spinal anaesthesia for your spinal laminectomy surgery.

Suitable For

Patients who are typically recommended spinal laminectomy are those suffering from conditions such as spinal stenosis, herniated discs, or other spinal disorders that are causing compression on the nerves in the spine. These patients may be experiencing symptoms such as leg pain, numbness, weakness, or difficulty walking due to the pressure on their spinal nerves. Spinal laminectomy is a surgical procedure that involves removing part of the lamina (the bony arch on the vertebrae) to relieve pressure on the spinal cord or nerves.

Patients who have not responded to conservative treatments such as physical therapy, medications, or injections may be candidates for spinal laminectomy. Additionally, patients who have severe symptoms that are significantly impacting their quality of life and daily activities may also be recommended for this surgery.

It is important for patients to undergo a thorough evaluation by a spine specialist to determine if spinal laminectomy is the appropriate treatment for their specific condition. The decision to undergo surgery should be made in collaboration with their healthcare provider after considering all potential risks and benefits.

Timeline

Before spinal laminectomy:

  1. Patient meets with a healthcare provider to discuss symptoms and potential treatment options.
  2. Patient undergoes a series of diagnostic tests such as X-rays, MRI, or CT scans to determine the extent of the spinal issue.
  3. Once the decision is made to proceed with surgery, the patient may need to undergo pre-operative testing such as blood work and a physical examination.
  4. The patient may receive instructions on how to prepare for surgery, including fasting before the procedure.

During spinal laminectomy:

  1. The patient is given either general anaesthesia or spinal anaesthesia before the surgery begins.
  2. The surgeon makes an incision in the back and removes a portion of the lamina to relieve pressure on the spinal cord or nerves.
  3. The surgery typically lasts for several hours, depending on the complexity of the case.
  4. After the procedure is completed, the patient is taken to a recovery room for monitoring.

After spinal laminectomy:

  1. The patient may experience pain and discomfort at the surgical site, which can be managed with pain medication.
  2. The patient is monitored for any potential complications such as infection or excessive bleeding.
  3. Physical therapy may be recommended to help the patient regain strength and mobility in the back.
  4. Follow-up appointments with the surgeon are scheduled to monitor the healing process and address any concerns.
  5. Over time, the patient should experience a reduction in symptoms such as pain, numbness, or weakness in the back and legs.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal laminectomy include:

  1. What are the potential risks and complications associated with spinal laminectomy?
  2. How does spinal anaesthesia compare to general anaesthesia in terms of safety and effectiveness for this procedure?
  3. Will I be awake during the surgery if I choose spinal anaesthesia?
  4. What are the potential side effects of spinal anaesthesia and how long do they typically last?
  5. How long is the recovery period after spinal laminectomy with spinal anaesthesia compared to general anaesthesia?
  6. Will I experience less pain and require less pain medication with spinal anaesthesia?
  7. How will my heart rate and blood pressure be monitored during the surgery if I choose spinal anaesthesia?
  8. Are there any specific pre-operative or post-operative instructions I should follow if I choose spinal anaesthesia?
  9. What is the success rate of spinal laminectomy with spinal anaesthesia compared to general anaesthesia?
  10. Are there any specific factors about my medical history or condition that may make one type of anaesthesia more suitable for me than the other?

Reference

Authors: Malik SH, Saleem H, Ashfaq AD, Malik IH, Batool F, Siddique K. Journal: J Ayub Med Coll Abbottabad. 2020 Jul-Sep;32(3):400-404. PMID: 32829559