Application of continuous epidural anesthesia in transforaminal lumbar endoscopic surgery: a prospective randomized controlled trial

J Int Med Res. 2019 Mar;47(3):1146-1153. doi: 10.1177/0300060518817218. Epub 2019 Jan 11.

Abstract

Objective: This study aimed to compare intraoperative lower back pain and leg pain, surgical time, and intraoperative X-ray dose in patients offered local infiltration anesthesia or continuous epidural anesthesia for transforaminal endoscopic spine system (TESSYS) surgery.

Methods: A total of 98 patients who received TESSYS treatment for single-segmental lumbar disc herniation were included, and were randomly divided into two groups: group A (49 cases; local infiltration anesthesia) and group B (49 cases; continuous epidural anesthesia). Surgical duration, intraoperative X-ray dose, and visual analog scale (VAS) scores of lower back pain and leg pain before surgery, during surgery, and 48 h after surgery were recorded and compared.

Results: After surgery, the VAS scores of both lower back pain and leg pain decreased in group A, and similar findings were found in group B. Group B had a shorter surgical duration, lower intraoperative X-ray dose, and lower intraoperative VAS scores of lower back pain and leg pain compared with group A.

Conclusion: Compared with local infiltration anesthesia, continuous epidural anesthesia was more effective for pain relief during TESSYS for single-segmental lumbar disc herniation, and also contributed to a shorter surgical duration and lower X-ray exposure.

Keywords: Lumbar disc herniation; epidural anesthesia; leg pain; local infiltration anesthesia; lower back pain; transforaminal endoscopic surgery system (TESSYS).

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthesia, Epidural / methods*
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Degeneration / surgery*
  • Intervertebral Disc Displacement / surgery*
  • Low Back Pain / prevention & control*
  • Lumbar Vertebrae / surgery*
  • Male
  • Prognosis
  • Prospective Studies

Supplementary concepts

  • Intervertebral disc disease