Mon, May 18, 2026
Volume 11 - Continuous Publishing
Iran J Neurosurg 2025, 11 - Continuous Publishing: 0-0 |
Back to browse issues page
Ethics code: IR.GUMS.REC.1403.146
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Mardvar A, Reihanian Z, Jafari S, Modaenama M, Yazdanipour M, Torkashvand M et al . Comparative Outcomes of Combined Spinal-general Anesthesia versus General Anesthesia in Lumbar Spine Fusion Surgery. Iran J Neurosurg 2025; 11 : 23
URL: http://irjns.org/article-1-505-en.html
URL: http://irjns.org/article-1-505-en.html
Afshin Mardvar *1 
, Zoheir Reihanian1 , Seifollah Jafari1 , Morteza Modaenama2 , Mohammadali Yazdanipour3 , Mahdieh Torkashvand4 , Ali Ashraf5
, Zoheir Reihanian1 , Seifollah Jafari1 , Morteza Modaenama2 , Mohammadali Yazdanipour3 , Mahdieh Torkashvand4 , Ali Ashraf5
1- Department of Neurosurgery, School of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran. & Road Trauma Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran
2- Department of Neurosurgery, School of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
3- Neuroscience Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran.
4- Poursina Clinical Research Development Unit, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
5- Poursina Clinical Research Development Unit, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran. & Department of Anesthesiology, School of Medicine, , Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
2- Department of Neurosurgery, School of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
3- Neuroscience Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran.
4- Poursina Clinical Research Development Unit, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
5- Poursina Clinical Research Development Unit, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran. & Department of Anesthesiology, School of Medicine, , Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
Abstract: (98 Views)
Background and Aim: In lumbar spine fusion surgeries, spinal anesthesia (SA) can enhance comfort and reduce postoperative pain compared to general anesthesia (GA). This study aimed to compare the preoperative and postoperative outcomes of the two approaches, given their unique advantages and disadvantages.
Methods and Materials/Patients: This randomized, single-blind clinical trial involved 48 patients aged 18-65, classified as American society of anesthesiologists (ASA) I or II, who were candidates for spinal fusion surgery. Participants were divided into two groups: General and spinal anesthesia (GSA, n=24) and GA (n=24). The primary outcome was hemodynamic changes, while the secondary outcomes focused on pain intensity and side effects, such as postoperative nausea, vomiting, and shivering. The key variables included vital signs, intraoperative blood loss, propofol and midazolam doses, and surgical duration from operating room entry to discharge from recovery.
Results: No significant differences in demographics or medical history were observed between the groups. The operative time was shorter in the GSA group (P=0.048). No notable differences were observed in terms of bleeding, nausea/vomiting, or shivering between the two methods. However, the median postoperative heart rate was significantly lower in the GSA group (P=0.007), and pain levels were also significantly reduced in both groups, with lower scores observed in the GSA group compared to GA (P=0.005). Hemoglobin levels decreased in both groups post-surgery (P<0.001). Repeated-measures analysis of variance (ANOVA) indicated significant effects on blood pressure, with GSA consistently showing lower readings than GA throughout the observation period.
Conclusion: Evidence from clinical trials indicates that combining GSA leads to shorter operative times, improved postoperative cardiac regulation, more stable intraoperative blood pressure, and better immediate pain control. These benefits promote the use of spinal anesthetic adjuvants in suitable surgical groups, ensuring hemodynamic stability without affecting recovery time or increasing bleeding risk. These findings are crucial for enhancing anesthetic practices and optimizing patient outcomes.
Methods and Materials/Patients: This randomized, single-blind clinical trial involved 48 patients aged 18-65, classified as American society of anesthesiologists (ASA) I or II, who were candidates for spinal fusion surgery. Participants were divided into two groups: General and spinal anesthesia (GSA, n=24) and GA (n=24). The primary outcome was hemodynamic changes, while the secondary outcomes focused on pain intensity and side effects, such as postoperative nausea, vomiting, and shivering. The key variables included vital signs, intraoperative blood loss, propofol and midazolam doses, and surgical duration from operating room entry to discharge from recovery.
Results: No significant differences in demographics or medical history were observed between the groups. The operative time was shorter in the GSA group (P=0.048). No notable differences were observed in terms of bleeding, nausea/vomiting, or shivering between the two methods. However, the median postoperative heart rate was significantly lower in the GSA group (P=0.007), and pain levels were also significantly reduced in both groups, with lower scores observed in the GSA group compared to GA (P=0.005). Hemoglobin levels decreased in both groups post-surgery (P<0.001). Repeated-measures analysis of variance (ANOVA) indicated significant effects on blood pressure, with GSA consistently showing lower readings than GA throughout the observation period.
Conclusion: Evidence from clinical trials indicates that combining GSA leads to shorter operative times, improved postoperative cardiac regulation, more stable intraoperative blood pressure, and better immediate pain control. These benefits promote the use of spinal anesthetic adjuvants in suitable surgical groups, ensuring hemodynamic stability without affecting recovery time or increasing bleeding risk. These findings are crucial for enhancing anesthetic practices and optimizing patient outcomes.
Article number: 23
Keywords: Lumbar spine, Fusion surgery, Postoperative pain, General anesthesia, Spinal anesthesia Hemodynamic
| Rights and Permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Copyright © The Author(s);
This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Contact Information
This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Contact Information
