Comparison Of The Effect Between Local And Epidural Anesthesia On The Treatment Of Lumbar Disc Herniation Under Percutaneous Transforaminal Endoscopic Discectomy

Objective:Percutaneous endoscopic lumbar discectomy is a minimally invasive operation to treat lumbar disc herniation.At present,the main anesthesia method for PELD is local anesthesia.The advantage of local anesthesia is that patients are awake and the nerves can be monitored.However,local anesthesia cannot fully relieve pain,which causes some patients cannot tolerate it and makes the operation become difficult.Low-concentration epidural anesthesia can preserve motor function while relieving pain and also play a role in monitoring nerves,but there are a few studies in the field.The main purpose of this study is to compare the efficacy of PELD treaing lumbar disc herniation between local anesthesia and epidural anesthesia.Method:This study is a retrospective study.According to inclusion and exclusion criteria,A total of 98 patients with single-segment LDH underwent PELD at Jiangxi Provincial People’s Hospital from January 2018 to July 2019 were included in this study.According to the different methods of anesthesia,they are divided into A and B groups.Among them,56 cases in group A underwent PELD under local anesthesia and 42 cases in group B under epidural anesthesia.These parameters were recorded such as the operation time,intraoperative blood pressure,intraoperative blood loss,intraoperative complication.The preoperative,intraoperative and postoperative Pain Visual Analogue Scale(VAS)scores,Oswestry Disability Index(ODI)scores before and 6 months after operation,and willingness to reoperation 24 hours after operation were also recorded.SPSS 19.0 software was used for statistical analysis.Results:The 98 patients successfully completed the operation.There were 3 patients relapsed in group A and 1 patient relapsed in group B,and no other serious complications were found.There was no statistically significant difference in operation time,intraoperative blood pressure,and intraoperative blood loss between the two groups(P>0.05).There was no statistically significant difference in the average VAS score before operation,1 week after operation and 6 months after operation,There was no statistically significant difference and average ODI scores before operation and 6 months after operation(P>0.05).The average intraoperative VAS score of group A(5.21±0.53)was significantly higher than that of group B(2.34±0.86),and the difference was statistically significant(P<0.05).The willingness to reoperation between the two groups of patients in group A(83.7%)was significantly lower than that in group B(95.4%),and the difference was statistically significant(P<0.05).Conclusion:PELD under epidural anesthesia or local anesthesia both can achieve similar clinical effects,but epidural anesthesia has a better analgesic than local anesthesia and is worthy of promotion.