Perioperative Complications Associated with Spinal Versus General Anesthesia in Adult Surgical Patients: A Comparative Study

Abstract

Spinal and general anesthesia are common methods of adult surgical patients, and each is characterized by unique physiological effects and complication rates. To maximize the outcomes of perioperative conditions, it is necessary to understand their relative safety. The purpose of the study is to compare the complications during the perioperative period between general and spinal anesthesia in adult patients undergoing elective surgery. Prospective comparative study was done at Al-Salam Teaching Hospital involving 100 patients aged 1865 years (ASA I-III). Patients were divided into two groups (spinal anesthesia n = 50 and general anesthesia n = 50). Intraoperative hemodynamics and perioperative complications such as: hypotension, bradycardia, respiratory complications, postoperative nausea and vomiting (PONV), headache, and urinary retention had to be noted and analyzed. There were similar baseline characteristics across groups (p > 0.05). The rates of hypotension (40% vs. 20; p = 0.03) and bradycardia (25% vs. 10; p = 0.04) were higher in the spinal anesthesia group. Conversely, general anesthesia experienced considerably more respiratory problems (18% vs. 4%; p = 0.02) and PONV (35% vs. 15%; p = 0.02). Post-dural puncture headache (18% vs. 5%; p = 0.04) and urinary retention (22% vs. 10%; p = 0.05) were more frequent in the spinal group. The rates of overall complications were similar in groups (p > 0.05). There are varying perioperative complication profiles in spinal and general anesthesia. Spinal anesthesia is more prone to the occurrence of hemodynamic instability and less prone to respiratory complications, but general anesthesia is prone to higher PONV and respiratory risks. The decision on anesthetic method must be personalized in regard to the patient's features and the operation's needs.