Ventilation Mode and Epidural Bleeding in Microdiscectomy: Comparison of Two Ventilation Techniques

Area of Science:

• Anesthesiology
• Neurosurgery
• Surgical Techniques

Background:

• Epidural bleeding during prone lumbar microdiscectomy can complicate surgery.
• Previous studies have not established a clear link between ventilation strategy and epidural bleeding in this position.

Purpose of the Study:

• To compare two ventilation protocols for their effect on epidural bleeding during lumbar microdiscectomy.
• To assess the impact of ventilation on intra-abdominal pressure and surgeon satisfaction.

Main Methods:

• Forty patients (ASA I-II) undergoing lumbar microdiscectomy were divided into two groups.
• Group A used high volume-low frequency ventilation; Group B used low volume-high frequency ventilation.
• Epidural bleeding was measured by aspiration volume; intra-abdominal pressure was monitored via urinary catheter.

Main Results:

• Low volume-high frequency ventilation (Group B) resulted in significantly less epidural bleeding (26.35 ± 6.59 ml) compared to high volume-low frequency ventilation (Group A, 43.9 ± 11.82 ml).
• Intra-abdominal pressure remained within normal limits in both groups.
• Surgeon satisfaction was higher in the low volume-high frequency group.

Conclusions:

• High frequency-low tidal volume ventilation can minimize epidural bleeding during lumbar microdiscectomy.
• This ventilation technique may improve surgical convenience by reducing bleeding and maintaining lower peak airway pressures.