| Purpose: To evaluate the clinical efficacy of regional block anesthesia and general anesthesia in percutaneous endoscopic interlaminar discectomy(PEID).Methods: A retrospective analysis of 71 patients with lumbar disc herniation(LDH)treated with PEID admitted to the People’s Hospital of Hebei Province from January 2019 to December 2021,and the patients were divided into two groups according to the anesthesia method,in which23 patients underwent spinal endoscopic surgery under general anesthesia and 48 patients underwent surgery under regional block anesthesia.The operative time,postoperative bed rest time,visual analogue score(VAS),Oswestry disability index(ODI),Macnab prognostic criteria,adverse effects,complications and anesthesia satisfaction rate were collected for both groups.Results: 71 patients with LDH underwent PEID surgery under different anesthesia,and the differences between the two groups in terms of gender,age,and surgical segment were not statistically significant(P >0.05).The postoperative hospital stay in the general anesthesia group was(3.96±1.30)days compared with the regional block anesthesia group(3.67±1.55)days,and there was no significant difference between the two groups(P=0.44).Compared with the general anesthesia group(84.65±22.01)minutes,the operation time of the regional block anesthesia group(68.25±20.48)minutes was significantly shortened(P=0.003).No significant difference was detected between the two groups in Macnab satisfaction(P=0.80).There was no significant difference in the preoperative VAS score of back pain between the general anesthesia group and the regional block anesthesia group((2.48±0.99 VS 2.81±1.12,P=0.23).One day after operation(2.00± 0.85 VS 1.83±0.75,P=0.41),one week after operation(1.43±0.59 VS 1.31±0.72,P=0.48)and six months after operation(0.87±0.76 VS 0.85±0.68,P=0.93).In terms of VAS score of leg pain,there was no significant difference between the two groups before operation(7.61±1.23 VS 7.71±1.16,P=0.73),1 day after operation(2.26±0.81 VS 2.17±1.04,P=0.70),1 week after operation(1.74±0.81 VS 1.79±0.85,P=0.35)and 6 months after operation(1.13±0.69 VS 1.08 ±0.79,P=0.81).Similarly in terms of ODI scores,the comparison between the two groups was(P=0.58)before surgery,1 day after surgery(P=0.42),and 1 week after surgery(P=0.65),and 6 months after surgery(P=0.71),there was no significant difference between the two groups.There were 2 cases of Post-Operative Dysesthesia(POD)in the regional block anesthesia group,and 3 cases in the general anesthesia group had similar symptoms(P=0.78).In the regional block anesthesia group,2 cases experienced postoperative hypotension.Likewise,1 patient in the general anesthesia group had a similar situation(P=0.99).Postoperative deep vein thrombosis occurred in 3 patients in the general anesthesia group,but not in the regional block anesthesia group(P=0.03).In the general anesthesia group,5 patients had nausea(P=0.01);4patients had vomiting(P=0.08);13 patients had postoperative pharyngeal discomfort(P<0.001).In addition,postoperative delirium occurred in 3patients in the general anesthesia group(P=0.01).In the regional block anesthesia group,there were 1 patient experienced nausea and 2 patients vomited,and no adverse reactions such as pharyngeal discomfort were observed.There were 2 cases of nerve root injury in the general anesthesia group,but not in the regional block anesthesia group(P=0.10).There was 1 patient in the general anesthesia group,and 2 patients in the regional block anesthesia group relapsed after surgery(P=0.97).In terms of satisfactory rate of anesthesia,it was 56.52% in the general anesthesia group and 87.50% in the regional block anesthesia group.The satisfaction degree of the regional block anesthesia group was higher,and the difference was statistically significant(P=0.006).Conclusions1 General anesthesia and regional block anesthesia have the same clinical curative effect after surgery and during follow-up,but the risk of nerve injury in the general anesthesia group is higher than that in the regional block anesthesia group,and regional block anesthesia better guarantees surgical safety.2 A variety of postoperative complications occurred in the general anesthesia group,including lower limb deep venous thrombosis and delirium,which brought obstacles to the postoperative rehabilitation of the patients.Regional block anesthesia is more in line with the concept of accelerated rehabilitation.3 The satisfaction of patients under general anesthesia was lower than that of patients under regional block anesthesia because of postoperative pharyngeal discomfort,nausea,vomiting and other adverse reactions. |
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