Objective: To analyze and compare postoperative recovery metrics and outcomes in patients undergoing short-duration uniportal endoscopic lumbar discectomy under spinal anesthesia utilizing bupivacaine versus chloroprocaine. Methods: This retrospective study analyzed 24 single-level uniportal endoscopic discectomy cases. Patients received spinal anesthesia in the lateral decubitus position with either bupivacaine (n=12) or chloroprocaine (n=12), with all procedures performed by the same surgeon. Primary postoperative outcomes included motor block duration, time to mobilization and ambulation, postoperative visual analogue scale (VAS) scores, requirement for urinary catheterization, and time to discharge from the Post Anesthesia Care Unit (PACU). Results: A statistically significant difference (p<0.05) was observed in postoperative recovery metrics between the 2 groups. The chloroprocaine group demonstrated expedited postoperative milestones, including earlier ambulation, reduced PACU length of stay, and a more rapid initiation of postoperative rehabilitation compared to the bupivacaine group. Conclusion Spinal anesthesia with chloroprocaine facilitates accelerated postoperative recovery, positioning it as a favorable alternative for short-duration uniportal endoscopic lumbar discectomy. However, its judicious utilization should be restricted to surgical procedures anticipated to last less than 1 hour given its pharmacokinetic profile.

The fully endoscopic technique has become the most effective and safest option for the treatment of lumbar disc herniation. Specifically, the interlaminar approach, which was first described at the beginning of the 21st century, is used for the treatment of L4–5 and L5–S1 intracanal disc herniation. Learning protocolized maneuvers facilitates reproducibility and increases the safety of the procedure. The description of the main maneuvers in this article aims to reduce complications and the learning curve with their widespread implementation.

Objective: In lumbar endoscopic spinal surgery, the choice of a regional anesthetic is important for reducing complications and can affect patient recovery and comfort. Methods: A retrospective analysis was conducted of 66 lumbar microdiscectomies (LMDs) under epidural anesthesia (EA) (n=45) or intradural anesthesia (IA) (n=21) performed by the same surgeon and anesthesiologist. The choice of regional anesthesia in LMD (epidural or intradural) differs between anesthesiologists, and the most frequently anesthetic method used in LMD is general or IA. Results: EA may be more reliable than IA, as it enables the surgeon to perform a neurological exploration by requesting the patient to make leg or foot movements during surgery, but few studies have compared these 2 anesthetic methods in LMD. We found that there was a statistically significant difference (p<0.05) between the 2 groups in the postoperative recovery times and in the use of vasopressors during surgery. Conclusion We suggest that EA reduces the length of time to ambulate, length of stay in the postanesthesia care unit, and the time until initiation of postoperative rehabilitation. Compared to IA, it offers greater hemodynamic stability and allows neurological exploration during surgery.