The Effects Of Epidural Anesthesia In Lumbar Transforaminal Endoscopic Surgery : A Prospective Randomized Controlled Trial

Background:Transforaminal Endoscopic Surgery System(TESSYS)is a standard technique for the treatment of lumbar disc herniation.Although most surgeons glad to choose local anesthesia,there are most of patients who complain of suffering a severe pain and are unable to cooperate with the surgery during operation.Reports regarding the use of epidural anesthesia are few in comparison.Objective:To investigate the use of epidural anesthesia in the operation of TESSYS,through compare statistics between local anesthesia and epidural anesthesia.Methods: From January 2016 to July 2016,patients treated with TESSYS due to lumbar disc herniation within single level in our hospital were selected.Patients were randomly divided into two groups:group A,local infiltration anesthesia with concentration of 0.2% mixed with 0.4% lidocaine solution,ensure that all levels of organization structure in the process were covered;group B,continuous epidural anesthesia with concentration of 0.3% ropivacaine solution in the process of operation.Use VAS score to evaluate the pain in different period.Operation time,intraoperative X-ray quantity,preoperative lumbar and leg pain VAS score,intraoperative lumbar and leg pain VAS score,48 hours after lumbar and leg pain VAS score were recorded,and SPSS 19.0 software was used for statistical analysis.Results: In the beginning,a total of 101 patients were included in the study,45 patients in group A,and 56 patients in group B.But 3 patients of group A dropped because of intraoperative pain and associated complications in the following.So there were 98 patients finished the study in the final,42 patients in group A,and 56 patients in group B.48 hours after lumbar and leg pain VAS score of two groups,group A(1.93±0.712,1.57±1.579),group B(1.18±0.811,1.25±1.643)were significantly lower than that of preoperation,group A(4.88±2.725,8.71±1.954),group B(5.20±3.153,8.23±2.054),the difference was statistically significant(P ? 0.05).Operation time(64.91±24.981min),intraoperative X-ray quantity(4.61±3.073 m GY)and intraoperative lumbar and leg pain VAS score(1.25±1.164,1.38±1.484)of group B were significantly lower than that of group A(118.71±24.598 min,14.77 ±3.095 m GY,4.67±1.18,5.67±1.883),the difference was statistically significant(P<0.05).Conclusion:Continuous epidural anesthesia can significantly improve the experience of patients in the operation of TESSYS who are suffering lumbar disc herniation within single level,shorten the operation time,reduce the X-ray exposure to patients and doctors when compare with local anesthesia,and is worth being popularized.