Strategies of anesthesia in percutaneous endoscopic lumbar discectomy: a prospective randomized controlled trial

English Keywords:Percutaneous endoscopic lumbar discectomy(PELD)  Anesthesia  Pain control  randomized controlled trial

English Abstract:

  【Abstract】 Objectives: To investigate the effect of different local infiltration anesthesia on paincontrol with percutaneous endoscopic lumbar discectomy(PELD). Methods: From February 2015 to June 2015, patients treated with PELD due to lumbar disc herniation in our hospital were selected. Patients were randomly divided into two groups: group A, 1% lidocaine dilution solution; group B, ropivacaine hydrochloride injection 100mg on the basis of group A, with fentanyl citrate injection 0.05mg and ondansetron hydrochloride injection 8mg at pre-operation. The pain control effect was evaluated by VAS scores at the time of lumbar foraminoplasty and annulus fibrosus operation, and re-operation intention immediately after operation and 24 hours after operation. Results: A total of 82 patients were included in the study, 42 patients in group A, and 40 patients in group B. The average pain VAS score(1.1±0.9) and the peak pain VAS score(1.3±0.9) of group B were significantly lower at the time of lumbar foraminoplasty than those of group A(3.2±2.4, 5.1±2.3). There was no significant difference of VAS scores at the time of annulus fibrosus operation between two groups. Re-operation intention of group B was significantly higher than that of group A(95.0% vs 71.4%) immediately after operation, and there was no significant difference between two groups(97.5% vs 97.6%) 24 hours after operation. There were no anesthesia and surgery related complications in two groups． Conclusions: Local anesthesia by using lidocaine and ropivacaine, combined with intravenous fentanyl, can significantly improve the pain control in lumbar endoscopic surgery with no increase of surgical risk.