General Anaesthesia vs Spinal Anaesthesia in Laparoscopic Cholecystectomy; safety, feasibility and affordability in rural Hospital in India

Utpal kumar Ray, Assistant Professor, Department of Anaesthesiology, Murshidabad Medical College & Hospital, Berhampore, West Bengal, India, Ranjan Bhattacharyya, Assistant Professor & Head of the Department, Deptt of Psychiatry, Murshidabad Medical College & Hospital, West Bengal, India
2018 The Journal of Medical Research  
General anaesthesia is choice of laparoscopic cholecystectomy (GA). Spinal anaesthesia is usually preferred in patients where general anaesthesia is contraindicated. In this study, the Spinal anaesthesia was used in 67 patients in whom LC was planned (study group). Methods: Laparoscopic cholecystectomy(LC) has been conventionally done under general anaesthesia. Regional anaesthesia is usually preferred in patients where GA is contraindicated. Spinal anaesthesia was used in 67 patents for
more » ... copic cholecystectomy (study group). 50 patients were given GA as control group. There was no modification in the technique, and the intra-abdominal pressure was kept 8mm of Hg to10 mm of Hg. Sedation was given if required, and conversation to general anaesthesia was done in patients not responding to sedation or with failure of spinal anaesthesia. Results: Out of 67 patients, two patients required conversation to GA. Hypotension requiring support was recorded in 14 (20.89%) patients and 16(23.88%) experienced neck or shoulder pain or both.Postoperatively,2(2.9%) patients had vomiting as compared 17(34%) of patients who were administered GA. Injectable diclofenac was required in 25(37.3%) of patients for abdominal pain within 2hours postoperatively and oral analgesic 53(79.10%) patients within the first 24 hours in SA group. However, 96% of patients operated under GA required injectable analgesics in the immediate postoperative period. Postural headache was experienced by 5(7.46%) patients post-operatively. Average time of discharge was 1.9 in patients operated under S.A compared to2.1 days in G.A group. Conclusion: There is no risk of intubation-related airway obstruction, little risks of unrecognized hypoglycaemia in a diabetic patient, excellent muscle relaxation, decreased surgical bed oozing and a more rapid return of gut function when laparoscopic cholecystectomy is done using SA compared with GA.
doi:10.31254/jmr.2018.4206 fatcat:24z6rnd2zvazvkvtf5fhranq3a