Spinal or General anaesthesia for lumbar spine microdiscectomy Surgery…does it matter?

Background : Prospective randomised study comparing immediate postoperative pain and satisfaction levels in patients having spinal versus general anaesthesia for single level lumbar microdiscectomy. Methods: Fifty consecutive patients were recruited and prospectively randomised into two equal groups, with half the patients receiving a spinal anaesthetic and the remainder a general anaesthetic. A comprehensive postoperative evaluation was carried out documenting any anaesthetic complication, pace of physiological and functional recovery and patient satisfaction. Results : Spinal anaesthesia patients achieved the milestones of physiological and functional recovery more rapidly and reported less postoperative pain. However the requirement for urinary catheterisation in this group was significantly higher. Conclusion: Despite better postoperative pain and functional outcomes for the spinal anaesthetic group and reported higher level of satisfaction when compared with general anaesthesia, the higher level of urinary retention in this group makes it impossible to perform this surgery as a day case procedure.