title: Spinal anesthesia for elective lumbar spine surgery.
abstract: OBJECTIVE
  To evaluate a large series of elective lumbar spine surgical procedures by a single surgeon whose patients were all offered spinal anesthesia.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Tertiary-care teaching hospital.
  
  
  RESULTS
  The records of all elective lumbar spine procedures between 1984 and 1995 performed by one surgeon (GRB) were obtained, and 803 were identified. Of those 803 patients, 611 accepted spinal anesthesia. Data collected included patient demographics, details of the spinal and general anesthesia, perioperative complications, and impact of the spinal anesthetic options on the outcome of spinal anesthesia. General and spinal anesthesia patients were comparable for age, gender, height, and ASA physical status. Patients who received spinal anesthesia were significantly heavier than the general anesthesia patients. Among perioperative complications, nausea and deep venous thrombosis occurred significantly more often in the general than spinal anesthesia patients. Mild hypotension and decreased heart rate (HR) were the most common hemodynamic changes with spinal anesthesia, whereas hypertension and increased HR were the result of general anesthesia. Among spinal anesthetic drugs, plain bupivacaine was associated with the lowest incidence of supplemental local anesthetic use intraoperatively compared to hyperbaric bupivacaine or hyperbaric tetracaine.
  
  
  CONCLUSIONS
  Spinal anesthesia is an effective alternative to general anesthesia for lumbar spine surgery and has a reduced rate of minor complications.
authors.affiliation: Department of General Anesthesiology, Cleveland Clinic Foundation, OH 44195, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Tetzlaff
authors.forename: J A
authors.initials: JA
authors.lastname: Dilger
authors.forename: M
authors.initials: M
authors.lastname: Kodsy
authors.forename: J
authors.initials: J
authors.lastname: al-Bataineh
authors.forename: H J
authors.initials: HJ
authors.lastname: Yoon
authors.forename: G R
authors.initials: GR
authors.lastname: Bell
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage; D001827:Body Height; D001835:Body Weight; D002045:Bupivacaine / Q000008:administration & dosage; D017558:Elective Surgical Procedures; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007022:Hypotension / Q000209:etiology; D007431:Intraoperative Complications; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D011312:Pressure; D012189:Retrospective Studies; D013748:Tetracaine / Q000008:administration & dosage; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology
chemical_list: D000779:Anesthetics, Local; D013748:Tetracaine; D002045:Bupivacaine