A prospective, randomized, controlled trial comparing the results of microdiscectomy under regional and general anesthesia

The purpose of this study was to evaluate and compare the results of microlumbar discectomy under regional anesthesia and under general anesthesia. This prospective, randomized, controlled trial was performed between October 2001 and March 2002 at Ramathibodi Hospital. Eighteen patients with lumbar disc herniation treated by microlumbar discectomy and followed in the same spinal protocol were randomly divided into two groups according to the anesthetic procedure: those under regional anesthesia and those under general anesthesia. Preoperative, postoperative, and long-term follow-up data were recorded. Ten patients were recruited to the regional anesthesia group and eight to the general anesthesia group. There were no significant differences in age, staging, severity, or operative time. The mean ambulation time in the regional anesthesia group (12h) was significantly shorter than that in the general anesthesia group (48h). The mean length of hospital stay was 1.3 and 4 days, respectively. In both groups, only oral analgesic drugs were needed. There was only one minor complication in the regional anesthetic group in a patient who developed orthostatic hypotension. Microlumbar discectomy is one of the best methods, with minimal invasiveness, minimal soft tissue injury, and short hospital stay, especially when performed with the patient under regional anesthesia.