Awake Microtubular Spinal Decompression: A Step Towards Better Peri-Operative Patient Safety, and Satisfaction
Volume 7 | Issue 2 | July-December 2022 | Page: 01-06 | Goparaju VNR Praveen, Amit Chugh, Ameya Rangnekar, Vishal Kundnani, Mani Kant Anand, Abhijith Shetty, Sunil Chodavadiya, Saijyot Raut
DOI: https://doi.org/10.13107/ijs.2022.v07i02.37
Authors: Goparaju VNR Praveen [1], Amit Chugh [1], Ameya Rangnekar [1], Vishal Kundnani [1], Mani Kant Anand [1], Abhijith Shetty [1], Sunil Chodavadiya [1], Saijyot Raut [2]
[1] Department of Orthopaedics, Bombay Hospital and Medical Research Centre, Mumbai, Maharashtra, India.
[2] Department of Orthopaedics, Lilavati Hospital, Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Goparaju VNR Praveen,
Fellow, Association of Spine Surgeons in India, Bombay Hospital & Medical Research Centre, Mumbai, Maharashtra, India.
E-mail: praveen.gvnr@gmail.com
Abstract
Introduction: Microtubular decompression (MTD) being a short-duration surgery, with many advantages, has gained popularity and can be done either in general anaesthesia (GA) or awake techniques like spinal anaesthesia (SA). The authors ventured to assess perioperative parameters, quantify peri-operative complications as the primary aim and determine patient satisfaction as the secondary aim of the study.
Materials and Methods: It was a retrospective study performed over a period of ten years (2009–2019) and included 625 patients. The patients included were aged greater than 18 years, American Society of Anaesthesiologists (ASA) score 1, 2, or 3. Patients with ASA 4 or 5, spinal instability, infection, or revision surgeries were excluded.
Results: There is no significant difference in the complication rates. The clinical outcome in the form of VAS and ODI scores showed significant differences both in SA and GA groups at the final follow-up. The total anaesthetic, surgical times, mean arterial pressure (MAP), and heart rate (HR) perioperatively were longer in the GA group (P < 0.05). The perioperative blood pressures are lower in the SA group. The dissatisfaction rate is about 3.5%, of which the patients and a total of 88.5% of patients would like to opt for SA for future surgeries.
Conclusion: This study represents the ten-year experience with MTD operated either with SA or GA. Awake spinal surgery is promising and has the glaring benefits of better peri-operative hemodynamic stability, and faster recovery with reduced surgical and anaesthetic duration. Dissatisfaction rates can be decreased by better explanation and the patient’s decision.
Keywords: Awake spine surgery, Microtubular decompression, Hemodynamic parameters, Complications, Patient satisfaction.
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| How to Cite this Article: Praveen GVNR, Chugh A, Rangnekar A, Kundnani V, Anand MK, Shetty A, Chodavadiya S, Raut S | Awake microtubular spinal decompression: A step towards better peri-operative patient safety and satisfaction | International Journal of Spine | July-December 2022; 7(2): 01-06 | https://doi.org/10.13107/ijs.2022.v07i02.37 |
