徳島大学 教育・研究者情報データベース(EDB)

1. (英) Yamaya Seiji

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2. 手束 文威([徳島大学.大学院医歯薬学研究部.医学域.先端医学教育研究プロジェクト]/[徳島大学.大学院医歯薬学研究部.医学域.医科学部門.外科系.運動機能外科学])

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3. 杉浦 宏祐([徳島大学.病院.先端医科医療開発研究プロジェクト]/[徳島大学.病院.診療科.感覚·皮膚·運動機能科.整形外科])

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4. 竹内 誠([徳島大学.大学院医歯薬学研究部.医学域.連携研究部門(医学域).寄附講座系(医学域).地域運動器・スポーツ医学])

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5. 眞鍋 裕昭

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6. 森本 雅俊([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.外科系.運動機能外科学])

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7. 山下 一太([徳島大学.病院.診療科.感覚·皮膚·運動機能科.整形外科])

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8. 髙田 洋一郎

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9. 酒井 紀典([徳島大学.大学院医歯薬学研究部.医学域.連携研究部門(医学域).寄附講座系(医学域).地域運動器・スポーツ医学])

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10. 前田 徹

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11. 西良 浩一([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.外科系.運動機能外科学])

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(英) Risk Factor for Additional Intravenous Medication during Transforaminal Full-endoscopic Lumbar Discectomy under Local Anesthesia.

(英) Transforaminal full-endoscopic lumbar discectomy (TELD) can be performed under local anesthesia. However, there have been no reports on risk factors for a change in vital signs or the need for additional medications to maintain adequate analgesia during this procedure. The purpose of this study was to identify risk factors for additional intravenous medication during TELD under local anesthesia. The following factors were retrospectively evaluated in 113 consecutive patients who underwent TELD under local anesthesia at our institution: demographic characteristics, radiological features at the intervertebral disc level, distance between the superior articular process and the exiting nerve root, height of the intervertebral disc, height of the bulging disc, height of the intervertebral foramen, and distance from the insertion site to the spinous process on magnetic resonance imaging (MRI) and computed tomography (CT) scans of the lumbar spine. Logistic regression analysis was performed to determine factors associated with the need for additional drugs. In all, 23 cases (20.4%) required additional intraoperative medications because of hypertension, hypotension, bradycardia, or pain. Logistic regression analysis revealed that age (partial regression coefficient 0.05, p = 0.02) and bulging disc height (partial regression coefficient -0.7, p = 0.003) influenced the need for additional drugs. There were significant associations of need for additional intravenous medication with older age (>62 years) and a smaller bulging disc height (<8.2 mm). Patients with these factors require close monitoring for changes in vital signs or increasing pain when performing TELD under local anesthesia and may need additional intravenous medication.

1. (英) PublicationType: Journal Article