Prospective Randomized Control Trail Of Anesthesia Approaches In Percutaneous Endoscopic Lumbar Discectomy

ObjectivesTo investigate the effect of pain management by different anesthesia in percutaneous endoscopic lumbar discectomy(PELD).MethodsFrom January 2016 to June 2017,patients treated with PELD due to lumbar disc herniation in our department were included in the trial.Patients were randomly divided into two groups:Group A,local infiltration anesthesia;Group B,local infiltration anesthesia combined with spinal nerve posterior ramus block anesthesia.Anesthesia solution recipe:50mg/10ml Ropivacaine+0.2g/10ml Lidocaine+10ml N.S.The pain management effect was evaluated by VAS at lumbar foraminoplasty phase and annulus fibrosus operation phase,and reoperation intention postoperatively immediately and after 24 hours.Result97 patients were included in the research,48 in Group A and 49 in Group B.During lumbar foraminoplasty phase Peek VAS of Group A(5.0±1.9)was significantly higher than Group B(1.5±0.8),while no significant difference at average VAS(1.1±0.7&1.0±0.8).And during annulus fibrosus operation phase,there was no significant difference at either peek VAS or average VAS.Group A showed a significantly lower reoperation intention than Group A ostoperatively immediately(72.9%:91.8%),while no significant difference after 24 hours.In Group A,4 patients suffered transient lower limbs dysfunction,which was significantly more than in Group B.No difference from surgical time and intraoperative bleeding.ConclusionLocal infiltration anesthesia combined with spinal nerve posterior ramus block anesthesia can significantly improve the pain management in PELD with reducing the rate of transient dysfunction of lower limbs.