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Pro-Con Debate for Thenar Tissue Oxygenation in Prone Position during Lumbar Discectomy
Merve Nur Salih1, Leyla Kazancioglu2, Sule Batcik2
1Bayburt Government Hospital, Clinic of Anesthesiology and Reanimation, Bayburt, Türkiye.
Turkish Neurosurgery
|August 1, 2026
Summary
General anesthesia provides better thenar tissue oxygenation during posterior lumbar discectomy than spinal or epidural anesthesia. This finding is crucial for optimizing patient outcomes in prone position surgeries.
Area of Science:
- Anesthesiology
- Neurosurgery
- Physiology
Background:
- Posterior lumbar discectomy often requires prone positioning, potentially impacting tissue oxygenation.
- The choice of anesthesia (general, spinal, or epidural) may influence regional tissue oxygen saturation during such procedures.
Purpose of the Study:
- To compare regional tissue oxygen saturation in the thenar region among patients undergoing posterior lumbar discectomy under general anesthesia (GA), spinal anesthesia (SA), and epidural anesthesia (EA).
Main Methods:
- Ninety patients (ASA score I-III) were randomized into three anesthesia groups (GA, SA, EA).
- Near-infrared spectroscopy (NIRS) was used to monitor thenar tissue oxygen saturation (StO2).
- Peripheral oxygen saturation (SpO2) and mean arterial blood pressure (MAP) were continuously monitored.
Main Results:
- Demographic data, bleeding, and surgery duration were comparable across groups.
- Thenar tissue oxygen saturation (StO2) was significantly higher in the epidural anesthesia group compared to the spinal anesthesia group at 15, 30, and 45 minutes.
- General anesthesia demonstrated superior thenar tissue oxygenation compared to spinal and epidural anesthesia during the monitored period.
Conclusions:
- General anesthesia appears to offer superior thenar tissue oxygenation in the prone position during posterior lumbar discectomy compared to spinal and epidural anesthesia.
- These findings contribute to the ongoing discussion regarding anesthetic techniques and their impact on tissue perfusion during spinal surgery.
