Epidural during/Post spine surgery gives better outcomes

(HealthDay)—In patients undergoing reconstructive spine surgery, combined epidural and general anesthesia results in better pain control and other outcomes compared with general anesthesia plus narcotics, according to a study published in the July 1 issue of Spine.

Anna A. Ezhevskaya, M.D., from the Nizhny Novgorod Research Institute of Traumatology and Orthopedics in Russia, and colleagues randomly assigned 85 patients undergoing reconstructive spine surgery to epidural anesthesia and endotracheal anesthesia with sevoflurane during surgery and continuous epidural analgesia with ropivacaine, fentanyl, and epinephrine after surgery, or general anesthesia with sevoflurane and fentanyl and systemically administered opioids after surgery.

The researchers found that the group receiving epidural anesthesia experienced significantly less pain and nausea, earlier mobility, higher satisfaction, and significantly less introperative and postoperative blood loss. The epidural group also had lower levels of glucose, cortisol, and interleukins-1?, -6, and -10 postoperatively.

"Combined epidural/general anesthesia and postoperative epidural analgesia produced better pain control, less bleeding, and a lower surgical stress response than general anesthesia with postoperative systemically administered narcotic analgesia," Ezhevskaya and colleagues conclude.