title: Perioperative outcome and cost-effectiveness of spinal versus general anesthesia for lumbar spine surgery.
abstract: OBJECTIVE
  General anesthesia (GA) is the most commonly used anesthetic technique for spinal surgery. This study aimed to compare spinal anesthesia (SA) and GA in patients undergoing spinal surgery, in terms of perioperative outcome and cost effectiveness.
  
  
  METHODS
  The study included 80 patients with ASA (American Society of Anesthesiologists) physical status I-II. The patients were randomized to receive SA (n = 40) or GA (n = 40). Heart rate (HR), mean arterial blood pressure (MABP), blood loss, duration of surgery, duration of anesthesia, surgeon satisfaction, and duration in the post-anesthesia care unit (PACU) were recorded. Postoperative analgesic requirement, nausea and vomiting (PONV), perioperative hemodynamic variables, and anesthetic costs were determined.
  
  
  RESULTS
  HR and MABP were significantly higher in the GA group than in the SA group at the end of surgery and at PACU admission. Duration of anesthesia, surgeon satisfaction, postoperative analgesic requirement, and anesthetic costs were significantly higher in the GA group. Mean blood loss was lower in the SA group than in the GA group, but the difference was not significant. Duration of surgery, duration in the PACU, perioperative hemodynamic variables, and complications were similar in both groups.
  
  
  CONCLUSIONS
  SA could be considered a reliable alternative to GA in patients undergoing lumber spine surgery, as it is clinically as effective as GA, but more cost effective.
authors: Department of Anesthesiology and Reanimation, Ulus State Hospital, Ankara, Turkey. Electronic address: kahvecikadriye@gmail.com.
authors: Kadriye
authors: K
authors: Kahveci
authors: Department of Anesthesiology and Reanimation, Ankara Ataturk Training and Research Hospital, Ankara, Turkey. Electronic address: cihandoger@gmail.com.
authors: Cihan
authors: C
authors: Doger
authors: Department of Anesthesiology and Reanimation, Ankara Numune Training and Research Hospital, Ankara, Turkey. Electronic address: dilsenpinar@yahoo.com.
authors: Dilsen
authors: D
authors: Ornek
authors: Department of Anesthesiology and Reanimation, Ankara Numune Training and Research Hospital, Ankara, Turkey. Electronic address: dgokcinar@yahoo.com.
authors: Derya
authors: D
authors: Gokcinar
authors: Department of Anesthesiology and Reanimation, Ataturk Pulmonology Training and Research Hospital, Ankara, Turkey. Electronic address: drsemihaydemir@hotmail.com.
authors: Semih
authors: S
authors: Aydemir
authors: Department of Neurosurgery, Diskapi Training and Research Hospital, Ankara, Turkey. Electronic address: rftozay@hotmail.com.
authors: Rafet
authors: R
authors: Ozay
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000191:economics* / Q000379:methods; D000775:Anesthesia, Spinal / Q000191:economics* / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects; D003362:Cost-Benefit Analysis; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010149:Postoperative Pain / Q000188:drug therapy; D019990:Perioperative Care / Q000191:economics / Q000379:methods*; D013118:Spinal Cord Diseases / Q000523:psychology / Q000601:surgery*
keywords: Anesthesia; Costs; General; Spinal; Spine surgery