Comparing the Effectiveness and Safety Between General Anesthesia versus Epidural Anesthesia for Percutaneous endoscopic lumbar discectomy
Authors: Haibier Abuduwupuer , Yusufu Alimujiang , Xi MingLei , Yakufu Maihemuti , Lin Hang , Abudurexiti Tuerhongjiang 
Published: July 2023

Abstract
Background: Percutaneous endoscopic lumbar discectomy (PELD) intervertebral approach is a technique for the treatment of lumbar disc hernia. It is not certain whether general anesthesia（GA） or epidural anesthesia (EA) is more suitable for percutaneous transforaminal endoscopic discation.
Objective: Epidural anesthesia (EA) is recommended for percutaneous endoscopic transforaminal disc dissection, but a satisfactory pain management has not yet been achieved. The purpose of this study is to investigate the clinical efficacy of PELD in the treatment of lumbar disc herniation under epidural anesthesia versus general anesthesia (GA).
Methods: According to the inclusion criteria, 87 patients undergoing percutaneous interforaminal endoscopic discectomy from January 2023 to May 2023 were retrospectively screened, and the patients were divided into two groups according to the anesthesia method. Both groups were 1) general anesthesia group (n=52) and 2) epidural group (n=35). The following variables were reviewed in both groups: gender, age, body mass index (BMI), operation time, intraoperative blood loss, postoperative hospital day, surgical segment, previous basic medical history, disease history, duration, smoking history, alcohol history, previous lumbar theatre, hospital cost, surgical satisfaction, Macnab satisfaction and VAS score (preoperative, 1 day, 3 days, 7 days and January).
Results: A total of 87 patients were included in this study to compare the parameters between the epidural and general anesthesia group. There were 35 patients in the epidural group (age 49.42 ± 14.63) and 52 patients in the general anesthesia group (age 53.78 ± 14.90).① Preoperative data: Age, gender, disease duration, body mass index, hypertension, diabetes, coronary heart disease, nervous system, respiratory system, endocrine system, systemic diseases, smoking history and drinking history of the two groups were not significant (P> 0.05); however, the distribution of surgical segments between the two groups was significant (P <0.05).② Postoperative data: the operation time, intraoperative blood loss, postoperative hospital stay, surgical satisfaction and Macnab satisfaction were not significant (P> 0.05), the total hospitalization cost of epidural group was significantly lower than that of general anesthesia group, and the difference was significant (P <0.05).③ VAS score: No difference in VAS scores between the two groups (P> 0.05); in the postoperative day 3,7, and January was lower than that of the general anesthesia group, the difference was significant (P <0.05).Conclusion: The results show that the clinical effect of percutaneous endoscopic lumbar discectomy under epidural anesthesia or general anesthesia was basically the same, and the overall hospitalization cost and the VAS score of postoperative days 3,7 and January of patients under epidural anesthesia were lower than that of the general anesthesia group, and the hospitalization time and operation time were shorter.