Overview
The goal of this pilot clinical trial is to test the feasibility of conducting a randomized controlled trial that will examine the use of ropivacaine in the spinal anesthesia for patients undergoing elective 1- or 2-level lower spine surgery. This study aims to:
- Determine the rates of eligibility, recruitment, consent, and attrition
- Determine the acceptability among patients, surgeons, anesthesiologists, and nurses of doing spine surgery under spinal anesthesia
- Gather preliminary data on outcomes relevant to a future dose-finding study
Participants will be randomized to one of three treatment groups:
- General anesthesia with endotracheal tube
- Spinal anesthesia with bupivacaine
- Spinal anesthesia with ropivacaine
Eligibility
Inclusion Criteria:
- Adult patients who are equal to or greater than 18 years old
- Undergoing elective one or two-level lumbar surgery via posterior surgical approach in the prone position (between L2-S1)
- Expected surgery duration of no greater than 2 hours
- ASA Physical Status Class 1 to 3
- Patient can have either spinal anesthesia or general anesthesia
- Able to provide consent and understand information in English, and capable of answering questions in English
Exclusion Criteria:
- Allergy to either ropivacaine, bupivacaine, or local anesthetics
- Contraindications to spinal anesthesia (i.e. coagulopathy or on anticoagulants, severe aortic or mitral valve stenosis, sepsis or bacteremia, thrombocytopenia, high intracranial pressure, infection at the puncture site)
- Surgery is expected to take more than 2 hours
- Emergency surgery
- Previously had back surgery at the level of the spine currently being operated on
- Comorbidities that require the patient to undergo general anesthesia
- Inability to stay still during the surgery
- Inability to move legs preoperatively
- Body Mass Index (BMI) >35
- Multilevel severe spinal stenosis