Spine Surgery Under Spinal vs General Anesthesia: Prospective Analysis of Quality of Life, Fatigue, and Cognition

被引:28
作者
De Biase, Gaetano [1 ]
Gruenbaum, Shaun E. E. [2 ]
Quinones-Hinojosa, Alfredo [1 ]
Abode-Iyamah, Kingsley O. O. [1 ]
机构
[1] Mayo Clin, Dept Neurosurg, 4500 San Pablo Rd, Jacksonville, FL 32224 USA
[2] Mayo Clin, Dept Anesthesiol, Jacksonville, FL 32224 USA
关键词
Spinal anesthesia; Awake MIS-TLIF; MIS-TLIF; Awake surgery; Awake spine surgery; Quality of life; Postoperative fatigue; Postoperative cognitive dysfunction; FORM HEALTH SURVEY; LUMBAR SPINE; STENOSIS; FUSION; SCALE; METAANALYSIS; RELIABILITY; VALIDITY; ADULTS; BACK;
D O I
10.1227/NEU.0000000000001777
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND:There has recently been increasing interest in the use of spinal anesthesia (SA) for spine surgery. The literature that compared spine surgery under SA vs general anesthesia (GA) focused on safety, perioperative outcomes, and costs.OBJECTIVE:To test if SA is associated with less postoperative fatigue, cognitive dysfunction, and better quality of life in patients undergoing lumbar spine surgery compared with GA.METHODS:We conducted a prospective nonrandomized study in patients undergoing elective lumbar spine surgery under SA or GA by a single surgeon. Fatigue was assessed with the fatigue visual analog scale scale (0-10) and Chalder Fatigue Scale, quality of life with Medical Outcomes Study 12-item Short Form (SF-12), and differences in cognition with Mini-Mental State Examination. Patients were baselined before surgery and assessed again 1 mo after surgery.RESULTS:Fifty patients completed the study, 25 underwent surgery under SA and 25 under GA. The groups were homogeneous for baseline clinical characteristics, with no differences in preoperative fatigue, quality of life, and cognition. At 1 mo after surgery, SA compared with GA had better fatigue scores: fatigue visual analog scale (2.9 +/- 1.5 vs 5.9 +/- 2.3 [P < .0001]) and Chalder Fatigue Scale (11.2 +/- 3.1 vs 16.9 +/- 3.9 [P < .0001]). One month postoperatively, we observed a significant difference in the SF-12 physical component, with SA having 38.8 +/- 8.9 vs 29.4 +/- 10.3 (P = .002). We did not observe significant postoperative differences in the SF-12 mental component or Mini-Mental State Examination.CONCLUSION:Our study demonstrates that SA offers unique patient-centered advantages to GA for elective spine surgery. One month after surgery, patients who received SA had less postoperative fatigue and better quality of life.
引用
收藏
页码:186 / 191
页数:6
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