1. Risk Factor for Additional Intravenous Medication during Transforaminal Full-endoscopic Lumbar Discectomy under Local Anesthesia
- Author
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Seiji Yamaya, Kazuta Yamashita, Fumitake Tezuka, Masatoshi Morimoto, Koichi Sairyo, Toru Maeda, Toshinori Sakai, Kosuke Sugiura, Makoto Takeuchi, Hiroaki Manabe, and Yoichiro Takata
- Subjects
transforaminal full-endoscopic lumbar discectomy ,medicine.medical_specialty ,Nerve root ,complications ,Vital signs ,Logistic regression ,030218 nuclear medicine & medical imaging ,lumbar disc herniation ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Diskectomy, Percutaneous ,Local anesthesia ,Risk factor ,Intervertebral foramen ,Aged ,Retrospective Studies ,Lumbar Vertebrae ,medicine.diagnostic_test ,business.industry ,Endoscopy ,Magnetic resonance imaging ,Intervertebral disc ,minimally invasive spine surgery ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Original Article ,Neurology (clinical) ,business ,local anesthesia ,Intervertebral Disc Displacement ,030217 neurology & neurosurgery ,Anesthesia, Local ,Diskectomy - Abstract
Transforaminal full-endoscopic lumbar discectomy (TELD) can be performed under local anesthesia. However, there have been no reports on risk factors for a change in vital signs or the need for additional medications to maintain adequate analgesia during this procedure. The purpose of this study was to identify risk factors for additional intravenous medication during TELD under local anesthesia. The following factors were retrospectively evaluated in 113 consecutive patients who underwent TELD under local anesthesia at our institution: demographic characteristics, radiological features at the intervertebral disc level, distance between the superior articular process and the exiting nerve root, height of the intervertebral disc, height of the bulging disc, height of the intervertebral foramen, and distance from the insertion site to the spinous process on magnetic resonance imaging (MRI) and computed tomography (CT) scans of the lumbar spine. Logistic regression analysis was performed to determine factors associated with the need for additional drugs. In all, 23 cases (20.4%) required additional intraoperative medications because of hypertension, hypotension, bradycardia, or pain. Logistic regression analysis revealed that age (partial regression coefficient 0.05, p = 0.02) and bulging disc height (partial regression coefficient −0.7, p = 0.003) influenced the need for additional drugs. There were significant associations of need for additional intravenous medication with older age (>62 years) and a smaller bulging disc height (
- Published
- 2021