title: Epidural anesthesia as a novel anesthetic technique for anterior lumbar interbody fusion.
abstract: OBJECTIVE
  To determine if epidural anesthesia is a reasonable technique for anterior lumbar interbody fusion.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Academic university hospital.
  
  
  METHODS
  The charts of patients who underwent an anterior lumbar interbody fusion between January 1, 2001 and November 1, 2008 were reviewed. A total of 102 consecutive patients, of whom 19 received an epidural and 83 underwent general anesthesia, met inclusion criteria. Postoperative pain, nausea, opioid administration, operating room time, anesthesia time, Postanesthesia Care Unit (PACU) time, and total hospital time were compared.
  
  
  RESULTS
  In the PACU, patients receiving epidural anesthesia showed reductions in median immediate [numerical rating scale (NRS) 0 vs 7; P < 0.001] and peak (NRS 4 vs 8; P = 0.001) postoperative pain scores, and postoperative mean arterial pressure (69.7 vs 90.3; P < 0.001). Epidural anesthesia patients also needed significantly less intravenous morphine-equivalent medication both intraoperatively (5 vs 29; P < 0.001) and postoperatively (3.34 vs 10; P = 0.021).
  
  
  CONCLUSIONS
  Epidural anesthesia for anterior lumbar interbody fusion is potentially beneficial compared with general anesthesia, showing improved perioperative pain control.
authors: Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, B6/319 Clinical Science Center, Madison, WI 53792, USA. Kmschro1@wisc.edu
authors: Kristopher M
authors: KM
authors: Schroeder
authors: Cameron
authors: C
authors: Zahed
authors: Adi C
authors: AC
authors: Andrei
authors: Seungbong
authors: S
authors: Han
authors: Michael P
authors: MP
authors: Ford
authors: Thomas A
authors: TA
authors: Zdeblick
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000767:Anesthesia, Epidural / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods*; D001794:Blood Pressure; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007432:Intraoperative Period; D007902:Length of Stay; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid