title: General anesthesia versus combined epidural/general anesthesia for elective lumbar spine disc surgery: A randomized clinical trial comparing the impact of the two methods upon the outcome variables.
abstract: BACKGROUND
  General anesthesia (GA) is the most frequently used technique for lumbar spine disc surgery. The aim of this study was to compare the intraoperative variables and postoperative outcome after GA and combined general/epidural anesthesia (CEG) in patients undergoing elective lumbar spine disk surgery.
  
  
  METHODS
  Eighty patients who underwent one or two level of laminectomy/discectomy during a 2 year period were enrolled in this randomized controlled trial (RCT). They were randomly selected to undergo GA or CEG. The data recorded during surgery were: The patients' heart rate (HR), mean arterial blood pressure (MABP), amount of blood loss, and the medication used during anesthesia. The severity of pain score, total analgesic consumption, and complications were recorded in the postoperative period.
  
  
  RESULTS
  The MABP, HR, blood loss, and anesthetic medication were significantly lower in CEG group in comparison with that of GA group. In the postoperative period, the pain score and total analgesic requirement was lower in the CEG group and less complication were encountered in this group.
  
  
  CONCLUSIONS
  The results of this study revealed that CEG have some advantages over GA in reducing the blood loss and anesthetic medication during the operation and it is also more effective in control of pain with fewer complications during the postoperative period.
authors.affiliation: Department of Anaesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Khajavi
authors.forename: Mohammad Amir
authors.initials: MA
authors.lastname: Asadian
authors.forename: Farsad
authors.initials: F
authors.lastname: Imani
authors.forename: Farhad
authors.initials: F
authors.lastname: Etezadi
authors.forename: Reza Shariat
authors.initials: RS
authors.lastname: Moharari
authors.forename: Abbas
authors.initials: A
authors.lastname: Amirjamshidi
keywords: Bupivacaine; combined epidural/general anesthesia; fentanyl; laminectomy; pain
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