S1 Transforaminal Epidural Anesthesia in Percutaneous Transforaminal Endoscopic Discectomy: A Case-Series Study

Area of Science:

• Neurosurgery
• Anesthesiology
• Spinal Surgery

Background:

• Percutaneous transforaminal endoscopic discectomy (PTED) is a minimally invasive surgical technique for lumbar disc herniation.
• Anesthesia choice for PTED impacts patient and surgeon satisfaction with pain management.
• The efficacy of S1 transforaminal epidural block for PTED analgesia requires further investigation.

Purpose of the Study:

• To evaluate the effectiveness of the S1 transforaminal epidural block as an anesthesia technique for PTED.
• To assess patient pain levels and surgeon satisfaction during PTED performed under S1 epidural block.

Main Methods:

• Retrospective study of 60 patients with L4-L5 lumbar disc herniation undergoing PTED.
• All patients received S1 transforaminal epidural block anesthesia.
• Data collected included pre-operative, intra-operative, and post-operative pain scores, operation duration, onset time, and bleeding volume.

Main Results:

• Significant reduction in pain scores from 7.83 pre-operatively to 2.58 intra-operatively and 0.50 at 48 hours post-operatively (P < 0.001).
• Mean operation duration was 58.58 minutes, with a mean onset time of 10.08 minutes.
• Mean bleeding volume was 124.17 cc.

Conclusions:

• S1 transforaminal epidural anesthesia is a safe and effective option for PTED.
• This anesthesia provides good intra-operative analgesia and allows for patient consciousness, facilitating neurological monitoring.
• The S1 epidural block contributes to the overall success and patient cooperation during PTED procedures.