Regional Versus General Anesthesia for Spinal Surgery: A Randomized Controlled Trial Comparing Clinical Outcomes

Background: Spinal surgery can be performed under either general anesthesia (GA) or regional anesthesia (RA). Objectives: This study compared outcomes between two groups of patients undergoing spinal neurosurgery with RA versus GA. Methods: This randomized clinical trial was conducted in the Neurosurgery Ward of Imam Hossein Hospital, Tehran, Iran, from 2021-08-23 to 2022-08-23. Of 126 patients initially enrolled for spinal surgery, 26 were excluded. The remaining 100 patients were randomized into GA (n = 49) and RA (n = 51) groups. The primary outcome was operation duration. Secondary outcomes included blood loss, pain, hospital stay, and vital signs. Results: Baseline characteristics (mean age, gender, and surgery type) were similar between groups. Operation duration and anesthesia time were significantly shorter in the RA group [80.8 ± 27.9 vs 104.1 ± 43.7 minutes (P = 0.002) and 121.0 ± 30.6 vs 148.3 ± 43.8 minutes (P < 0.001), respectively]. Bleeding, nausea, and vomiting were higher in the RA group, while muscle relaxation was greater in the GA group (P < 0.05). Acetaminophen consumption was significantly higher in the GA group (P = 0.011). Both patient and surgeon satisfaction were significantly higher with RA (P < 0.05). Hemodynamics and headache incidence were comparable between groups. Conclusions: Regional anesthesia resulted in shorter surgery times and was preferred by both patients and surgeons for spinal procedures. Additionally, RA significantly reduced the need for analgesic administration.