title: General versus epidural anesthesia for lumbar microdiscectomy.
abstract: This study was a retrospective analysis of 850 lumbar microdiscectomy (LMD) under epidural anesthesia (EA; n=573) or general anesthesia (GA; n=277) performed by the same surgeon and paid by invoice to the Social Security Institution of the Turkish Republic between April 2003 and May 2013. Although GA is the most frequently used method of anesthesia during LMD, the choice of regional anesthetia (epidural, spinal or a combination of these) differs between surgeons and anesthetists. Studies have reported that EA in surgery for lumbar disc herniation may be more reliable than GA, as it enables the surgeon to communicate with the patient during surgery, but few studies have compared the costs of these two anesthetic methods in LMD. We found that EA patient costs were significantly lower than GA patient costs (p<0.01) and there was a statistically significant difference between the two groups in terms of the time spent in the operating room (p<0.01). There was no difference in the duration of surgery (p>0.05). The anesthetic method used during LMD affected the complication rate, cost and efficiency of operating room use. We suggest that EA is an anesthetic method that can contribute to health care cost savings and enable LMD to be completed with less nerve root manipulation and more comfort, efficacy, reliability and cost efficiency without affecting the success rate of the surgical procedure.
authors.affiliation: Department of Neurosurgery, Sanko University, Konukoglu Hospital, Ali Fuat Cebesoy Bulvari, Şehitkamil 7090, Gaziantep, Turkey. Electronic address: nrsrgn@yahoo.com.
authors.forename: Murat
authors.initials: M
authors.lastname: Ulutas
authors.affiliation: Department of Neurosurgery, Deva Hospital, Gaziantep, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Secer
authors.affiliation: Department of Neurosurgery, Uludag University Medical Faculty, Bursa, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Taskapilioglu
authors.affiliation: Department of Anaesthesiology, Sanko University, Konukoglu Hospital, Gaziantep, Turkey.
authors.forename: Soner
authors.initials: S
authors.lastname: Karadas
authors.affiliation: Department of Anaesthesiology, Sanko University, Konukoglu Hospital, Gaziantep, Turkey.
authors.forename: Ahmet Aykut
authors.initials: AA
authors.lastname: Akyilmaz
authors.affiliation: Department of Anaesthesiology, Sanko University, Konukoglu Hospital, Gaziantep, Turkey.
authors.forename: Yunus
authors.initials: Y
authors.lastname: Baydilek
authors.affiliation: Department of Anaesthesiology, Sanko University, Konukoglu Hospital, Gaziantep, Turkey.
authors.forename: Betul
authors.initials: B
authors.lastname: Kocamer
authors.affiliation: Department of Anaesthesiology, Sanko University, Konukoglu Hospital, Gaziantep, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Ozboz
authors.affiliation: Department of Neurosurgery, Acibadem Hospital, Bursa, Turkey.
authors.forename: Suat
authors.initials: S
authors.lastname: Boyaci
mesh_terms: D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural / Q000191:economics / Q000379:methods*; D000768:Anesthesia, General / Q000191:economics / Q000379:methods*; D003142:Communication; D017046:Cost Savings; D003365:Costs and Cost Analysis; D017586:Diskectomy / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000191:economics / Q000379:methods; D008875:Middle Aged; D009873:Operating Rooms / Q000458:organization & administration; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cost; Epidural anesthesia; General; Lumbar microdiscectomy