Risk Factor for Additional Intravenous Medication during Transforaminal Full-endoscopic Lumbar Discectomy under Local Anesthesia
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...
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| Veröffentlicht in: | Neurologia medico-chirurgica 2021, Vol.61(3), pp.236-242 |
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| creator | YAMAYA, Seiji TEZUKA, Fumitake SUGIURA, Kosuke TAKEUCHI, Makoto MANABE, Hiroaki MORIMOTO, Masatoshi YAMASHITA, Kazuta TAKATA, Yoichiro SAKAI, Toshinori MAEDA, Toru SAIRYO, Koichi |
| description | 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 ( |
| doi_str_mv | 10.2176/nmc.oa.2020-0275 |
| format | Article |
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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 (<8.2 mm). Patients with these factors require close monitoring for changes in vital signs or increasing pain when performing TELD under local anesthesia and may need additional intravenous medication.</description><identifier>ISSN: 0470-8105</identifier><identifier>EISSN: 1349-8029</identifier><identifier>DOI: 10.2176/nmc.oa.2020-0275</identifier><identifier>PMID: 33504730</identifier><language>eng</language><publisher>Japan: The Japan Neurosurgical Society</publisher><subject>Analgesia ; Anesthesia ; Bradycardia ; complications ; Computed tomography ; Endoscopy ; Hypotension ; Intervertebral discs ; Intravenous administration ; Local anesthesia ; lumbar disc herniation ; Magnetic resonance imaging ; minimally invasive spine surgery ; Original ; Pain perception ; Regression analysis ; Risk factors ; Spine (lumbar) ; transforaminal full-endoscopic lumbar discectomy</subject><ispartof>Neurologia medico-chirurgica, 2021, Vol.61(3), pp.236-242</ispartof><rights>2021 The Japan Neurosurgical Society</rights><rights>2021. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 The Japan Neurosurgical Society 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c786t-86ccf32978deb01fce89c48723cd5cbee90a1e24c7a580aa035c35bc291be95d3</citedby><cites>FETCH-LOGICAL-c786t-86ccf32978deb01fce89c48723cd5cbee90a1e24c7a580aa035c35bc291be95d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7966206/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7966206/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1877,4010,27900,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33504730$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>YAMAYA, Seiji</creatorcontrib><creatorcontrib>TEZUKA, Fumitake</creatorcontrib><creatorcontrib>SUGIURA, Kosuke</creatorcontrib><creatorcontrib>TAKEUCHI, Makoto</creatorcontrib><creatorcontrib>MANABE, Hiroaki</creatorcontrib><creatorcontrib>MORIMOTO, Masatoshi</creatorcontrib><creatorcontrib>YAMASHITA, Kazuta</creatorcontrib><creatorcontrib>TAKATA, Yoichiro</creatorcontrib><creatorcontrib>SAKAI, Toshinori</creatorcontrib><creatorcontrib>MAEDA, Toru</creatorcontrib><creatorcontrib>SAIRYO, Koichi</creatorcontrib><creatorcontrib>Tokushima University</creatorcontrib><creatorcontrib>Department of Orthopaedic Surgery</creatorcontrib><creatorcontrib>Department of Orthopedic Surgery</creatorcontrib><creatorcontrib>Department of Orthopedics</creatorcontrib><creatorcontrib>Tokushima Prefecture Naruto Hospital</creatorcontrib><creatorcontrib>Sendai Nishitaga National Hospital</creatorcontrib><title>Risk Factor for Additional Intravenous Medication during Transforaminal Full-endoscopic Lumbar Discectomy under Local Anesthesia</title><title>Neurologia medico-chirurgica</title><addtitle>Neurol. Med. Chir.(Tokyo)</addtitle><description>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 (<8.2 mm). Patients with these factors require close monitoring for changes in vital signs or increasing pain when performing TELD under local anesthesia and may need additional intravenous medication.</description><subject>Analgesia</subject><subject>Anesthesia</subject><subject>Bradycardia</subject><subject>complications</subject><subject>Computed tomography</subject><subject>Endoscopy</subject><subject>Hypotension</subject><subject>Intervertebral discs</subject><subject>Intravenous administration</subject><subject>Local anesthesia</subject><subject>lumbar disc herniation</subject><subject>Magnetic resonance imaging</subject><subject>minimally invasive spine surgery</subject><subject>Original</subject><subject>Pain perception</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Spine (lumbar)</subject><subject>transforaminal full-endoscopic lumbar discectomy</subject><issn>0470-8105</issn><issn>1349-8029</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNpVUcFu1DAQjRCIrkrvnFAkztmO7SR2LkirwpZKi5BQOVvOZHbXJbEXO6nUG5-O022XcpiZw7x5741elr1nsORM1pduwKU3Sw4cCuCyepUtmCibQgFvXmcLKCUUikF1ll3EaFsAXqpSKPk2OxOiSmsBi-zPDxt_5WuDow_5NtWq6-xovTN9fuPGYO7J-Snm36izaOZF3k3Bul1-G4yL6cIMdgavp74vyHU-oj9YzDfT0JqQf7YRKZEPD_nkOgr5xmNCrxzFcU_RmnfZm63pI108zfPs5_rL7dXXYvP9-uZqtSlQqnosVI24FbyRqqMW2BZJNVgqyQV2FbZEDRhGvERpKgXGgKhQVC3yhrXUVJ04zz4deQ9TO1CHND_X60OwgwkP2hur_984u9c7f69lU9cc6kTw8Ykg-N9Tsq_v_BTS61HzCmTTyJRKQsERhcHHGGh7UmCg59h0ii2p6Tk2PceWTj68dHY6eA4pAa6PgOExhN673jr6J48dczQFmjmZBqgZiDRkohd1aiUXslJKzVLrI9NdHM2OTlImjBZ7evRWMy3m9tLjCYB7EzQ58RcRd8es</recordid><startdate>2021</startdate><enddate>2021</enddate><creator>YAMAYA, Seiji</creator><creator>TEZUKA, Fumitake</creator><creator>SUGIURA, Kosuke</creator><creator>TAKEUCHI, Makoto</creator><creator>MANABE, Hiroaki</creator><creator>MORIMOTO, Masatoshi</creator><creator>YAMASHITA, Kazuta</creator><creator>TAKATA, Yoichiro</creator><creator>SAKAI, Toshinori</creator><creator>MAEDA, Toru</creator><creator>SAIRYO, Koichi</creator><general>The Japan Neurosurgical Society</general><general>THE JAPAN NEUROSURGICAL SOCIETY</general><general>Japan Science and Technology Agency</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>5PM</scope></search><sort><creationdate>2021</creationdate><title>Risk Factor for Additional Intravenous Medication during Transforaminal Full-endoscopic Lumbar Discectomy under Local Anesthesia</title><author>YAMAYA, Seiji ; TEZUKA, Fumitake ; SUGIURA, Kosuke ; TAKEUCHI, Makoto ; MANABE, Hiroaki ; MORIMOTO, Masatoshi ; YAMASHITA, Kazuta ; TAKATA, Yoichiro ; SAKAI, Toshinori ; MAEDA, Toru ; SAIRYO, Koichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c786t-86ccf32978deb01fce89c48723cd5cbee90a1e24c7a580aa035c35bc291be95d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Analgesia</topic><topic>Anesthesia</topic><topic>Bradycardia</topic><topic>complications</topic><topic>Computed tomography</topic><topic>Endoscopy</topic><topic>Hypotension</topic><topic>Intervertebral discs</topic><topic>Intravenous administration</topic><topic>Local anesthesia</topic><topic>lumbar disc herniation</topic><topic>Magnetic resonance imaging</topic><topic>minimally invasive spine surgery</topic><topic>Original</topic><topic>Pain perception</topic><topic>Regression analysis</topic><topic>Risk factors</topic><topic>Spine (lumbar)</topic><topic>transforaminal full-endoscopic lumbar discectomy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>YAMAYA, Seiji</creatorcontrib><creatorcontrib>TEZUKA, Fumitake</creatorcontrib><creatorcontrib>SUGIURA, Kosuke</creatorcontrib><creatorcontrib>TAKEUCHI, Makoto</creatorcontrib><creatorcontrib>MANABE, Hiroaki</creatorcontrib><creatorcontrib>MORIMOTO, Masatoshi</creatorcontrib><creatorcontrib>YAMASHITA, Kazuta</creatorcontrib><creatorcontrib>TAKATA, Yoichiro</creatorcontrib><creatorcontrib>SAKAI, Toshinori</creatorcontrib><creatorcontrib>MAEDA, Toru</creatorcontrib><creatorcontrib>SAIRYO, Koichi</creatorcontrib><creatorcontrib>Tokushima University</creatorcontrib><creatorcontrib>Department of Orthopaedic Surgery</creatorcontrib><creatorcontrib>Department of Orthopedic Surgery</creatorcontrib><creatorcontrib>Department of Orthopedics</creatorcontrib><creatorcontrib>Tokushima Prefecture Naruto Hospital</creatorcontrib><creatorcontrib>Sendai Nishitaga National Hospital</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurologia medico-chirurgica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>YAMAYA, Seiji</au><au>TEZUKA, Fumitake</au><au>SUGIURA, Kosuke</au><au>TAKEUCHI, Makoto</au><au>MANABE, Hiroaki</au><au>MORIMOTO, Masatoshi</au><au>YAMASHITA, Kazuta</au><au>TAKATA, Yoichiro</au><au>SAKAI, Toshinori</au><au>MAEDA, Toru</au><au>SAIRYO, Koichi</au><aucorp>Tokushima University</aucorp><aucorp>Department of Orthopaedic Surgery</aucorp><aucorp>Department of Orthopedic Surgery</aucorp><aucorp>Department of Orthopedics</aucorp><aucorp>Tokushima Prefecture Naruto Hospital</aucorp><aucorp>Sendai Nishitaga National Hospital</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factor for Additional Intravenous Medication during Transforaminal Full-endoscopic Lumbar Discectomy under Local Anesthesia</atitle><jtitle>Neurologia medico-chirurgica</jtitle><addtitle>Neurol. Med. Chir.(Tokyo)</addtitle><date>2021</date><risdate>2021</risdate><volume>61</volume><issue>3</issue><spage>236</spage><epage>242</epage><pages>236-242</pages><issn>0470-8105</issn><eissn>1349-8029</eissn><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 (<8.2 mm). Patients with these factors require close monitoring for changes in vital signs or increasing pain when performing TELD under local anesthesia and may need additional intravenous medication.</abstract><cop>Japan</cop><pub>The Japan Neurosurgical Society</pub><pmid>33504730</pmid><doi>10.2176/nmc.oa.2020-0275</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; J-STAGE (Japan Science & Technology Information Aggregator, Electronic) Freely Available Titles - Japanese; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Analgesia Anesthesia Bradycardia complications Computed tomography Endoscopy Hypotension Intervertebral discs Intravenous administration Local anesthesia lumbar disc herniation Magnetic resonance imaging minimally invasive spine surgery Original Pain perception Regression analysis Risk factors Spine (lumbar) transforaminal full-endoscopic lumbar discectomy |
| title | Risk Factor for Additional Intravenous Medication during Transforaminal Full-endoscopic Lumbar Discectomy under Local Anesthesia |
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