SPINAL ANESTHESIA IN SURGERY FOR DISCOGENIC LUMBOSACRAL RADICULITIS

Abstract

Objective. To analyze clinical efficacy of spinal anesthesia in surgery for discogenic lumbosacral radiculitis.

Material and Methods. Spinal anesthesia was applied in surgical treatment of 220 patients with discogenic lumbosacral radiculitis. The first group included patients in whom individual features of vegetative regulation were not considered, while patients from the second group were examined for initial preoperative vegetative tonus. Concentration of anesthetics (lidocaine and marcaine) in cerebrospinal fluid during spinal anesthesia was measured at 2 and 8 minutes after anesthesia induction.

Results. The rate of decrease of anesthetic concentration in cerebrospinal fluid is directly proportional to the onset time of sensory and motor blocks. Herniated disc compression on the dural sac disturbs liquor circulation and affects distribution of local anesthetics in cerebrospinal fluid. Authors suggest an algorithm of cerebrospinal anesthesia involving intermittent administration of minimum local anesthetic doses with assessment of sensory block level after 8 minutes, preoperative examination of vegetative tonus, and appropriate medication administration.

Conclusion. Suggested method allows for efficient and safe performing of surgical intervention.