Local Anesthesia Versus General Anesthesia in Percutaneous Interlaminar Endoscopic Discectomy: A Meta-analysis.

OBJECTIVE: To systematically evaluate the safety and efficacy of Local anesthesia (LA) and general anesthesia (GA) in percutaneous interlaminar endoscopic discectomy (PIED).

MATERIALS AND METHODS: We searched the MEDLINE, EMBASE, EuropePMC, PubMed, Web of Science, Cochrane databases, CNKI databases for all relevant studies. All statistical analysis was performed using Review Manager version 5.3.

RESULTS: A total of 6 articles with 549 study subjects were included, with 282 patients in LA group and 267 patients in GA group. The results of the meta-analysis showed that the LA group had significantly better results in hospital stay time (MD, -1.68; 95%CI, -3.35 to -0.01) and hospital costs (MD, -0.57, 95% CI, -1.02 to -0.12) compared with the GA group, while ODI (MD, 0.48; 95%CI, -0.07 to 1.04), VAS Scores (MD, -0.05; 95%CI, -0.24 to 0.13), postoperative transient dysesthesia and weakness (OR, 0.83, 95% CI, 0.40 to 1.69), dura and nerve root injury (OR, 0.21, 95% CI, 0.03 to 1.25), operation time (MD, -3.51; 95%CI, -11.5 to 4.48) and willingness rate to receive the same procedure(OR, 0.12, 95% CI, 0.01 to 1.00) showed no significant differences between the two groups.

DISCUSSION: LA can effectively relieve pain during PIED surgery and ensure the safety of operation without increasing the occurrence of postoperative complications. PIED under LA not only has similar patient satisfaction, but also shows obvious advantages in shortening hospital stay and reducing hospital costs compared with GA surgery.