Laparoscopic cholecystectomy under spinal anaesthesia: A prospective, randomised study
Open Access
- 1 January 2013
- journal article
- research article
- Published by Medknow in Journal of Minimal Access Surgery
- Vol. 9 (2), 65-71
- https://doi.org/10.4103/0972-9941.110965
Abstract
Context: Spinal anaesthesia has been reported as an alternative to general anaesthesia for performing laparoscopic cholecystectomy (LC). Aims: Study aimed to evaluate efficacy, safety and cost benefit of conducting laparoscopic cholecystectomy under spinal anaesthesia (SA) in comparison to general anaesthesia(GA) Settings and Design: A prospective, randomised study conducted over a two year period at an urban, non teaching hospital. Materials and Methods: Patients meeting inclusion criteria e randomised into two groups .Group A and Group B received general and spinal anaesthesia by standardised techniques. Both groups underwent standard four port laparoscopic cholecystectomy. Mean anaesthesia time, pneumoperitoneum time and surgery time defined primary outcome measures. Intraoperative events and post operative pain score were secondary outcome measure. Statistical Analysis Used: The Student t test, Pearson's chi-square test and Fisher exact test. Results: Out of 235 cases enrolled in the study, 114 cases in Group A and 110 in Group B analysed. Mean anaesthesia time appeared to be more in the GA group (49.45 vs. 40.64, P = 0.02) while pneumoperitoneum time and corresponding the total surgery time was slightly longer in the SA group. 27/117 cases who received SA experienced intraoperative events, four significant enough to convert to GA. No postoperative complications noted in either group. Pain relief significantly more in SA group in immediate post operative period (06 and 12 hours) but same as GA group at time of discharge (24 hours). No late postoperative complication or readmission noted in either group. Conclusion: Laparoscopic cholecystectomy done under spinal anaesthesia as a routine anaesthesia of choice is feasible and safe. Spinal anaesthesia can be recommended to be the anaesthesia technique of choice for conducting laparoscopic cholecystectomy in hospital setups in developing countries where cost factor is a major factor.Keywords
This publication has 25 references indexed in Scilit:
- Comments on “Laparoscopic Cholecystectomy Under Spinal Versus General Anesthesia: A Prospective, Randomized Study”—Can You Really Have the Conclusion?Journal of Laparoendoscopic & Advanced Surgical Techniques, 2011
- Laparoscopic Cholecystectomy Under Spinal Versus General Anesthesia: A Prospective, Randomized StudyJournal of Laparoendoscopic & Advanced Surgical Techniques, 2010
- A Prospective Randomized, Controlled Study Comparing Low Pressure Versus High Pressure Pneumoperitoneum During Laparoscopic CholecystectomySurgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2009
- Low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomyPublished by Wiley ,2009
- Prospective Randomized Trial on Low-pressure Versus Standard-pressure Pneumoperitoneum in Outpatient Laparoscopic CholecystectomySurgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2006
- Circulatory and Respiratory Complications of Carbon Dioxide InsufflationDigestive Surgery, 2004
- Laparoscopic cholecystectomy performed under regional anesthesia in patients with chronic obstructive pulmonary diseaseSurgical Endoscopy, 2001
- Prospective randomized trial of low-pressure pneumoperitoneum for reduction of shoulder-tip pain following laparoscopyBritish Journal of Surgery, 2000
- Acid–base balance alterations in laparoscopic cholecystectomySurgical Endoscopy, 1997
- The validation of visual analogue scales as ratio scale measures for chronic and experimental painPain, 1983