A Hospital Based Randomized Comparative Assessment of Laparoscopic Cholecystectomy under Spinal Anaesthesia vs General Anaesthesia
Authors/Creators
- 1. Senior Resident, Department of Anaesthesia, Shri Krishna Medical College, Muzaffarpur, Bihar
Description
Abstract
Aim: The aim of the present study was to evaluate the efficacy, safety and advantages of conducting LC under
SA in comparison to GA.
Methods: The study was conducted in the Department of Anaesthesia for 8 months . Informed consent was
obtained from all the patients who had agreed to participate in the study. A detailed explanation of the procedure
and risks involved was given. A total number of 70 patients were included in the study.
Results: Both the groups had similar demographic profile. In the SA group, 45 patients were females and 25
patients were males. The mean age was 46 ±12.68 years and 48.82 ±10.45 in SA and GA groups respectively.
The duration of surgery was 82.98±21.99 min and 98.2±36.04 min in the GA and SA groups which was not
statistically significant. For each procedure the surgeon was asked to give a score of 1-3, regarding the surgical
conditions and muscle relaxation; 1 was bad, 2 good and 3 being excellent. In the SA group, 8 patients
complained of shoulder pain, 3 patients required conversion to GA as the pain did not subside with Fentanyl and
they were excluded from further analysis. All the patients (100%) in the GA group had pain at operated site
immediately after completion of operation and their pain score ranged from 4-7, all patients received rescue
analgesic before shifting to the ward. In the first 24h tramadol required as rescue in the GA group was 84±26
mg which was significantly higher than the SA group requiring only 31±32.18 mg. Although, the GA group had
more patients experiencing postoperative nausea & vomiting it was not statistically significant.
Conclusion: We concluded that laparoscopic cholecystectomy can be safely performed under spinal anaesthesia
using bupivacaine and clonidine as an adjuvant. Spinal anaesthesia provides stable intra-operative
haemodynamic and respiratory parameters, requires less postoperative analgesics with extended duration of
analgesia, with no major complications and has better patient satisfaction
Abstract (English)
Abstract
Aim: The aim of the present study was to evaluate the efficacy, safety and advantages of conducting LC under
SA in comparison to GA.
Methods: The study was conducted in the Department of Anaesthesia for 8 months . Informed consent was
obtained from all the patients who had agreed to participate in the study. A detailed explanation of the procedure
and risks involved was given. A total number of 70 patients were included in the study.
Results: Both the groups had similar demographic profile. In the SA group, 45 patients were females and 25
patients were males. The mean age was 46 ±12.68 years and 48.82 ±10.45 in SA and GA groups respectively.
The duration of surgery was 82.98±21.99 min and 98.2±36.04 min in the GA and SA groups which was not
statistically significant. For each procedure the surgeon was asked to give a score of 1-3, regarding the surgical
conditions and muscle relaxation; 1 was bad, 2 good and 3 being excellent. In the SA group, 8 patients
complained of shoulder pain, 3 patients required conversion to GA as the pain did not subside with Fentanyl and
they were excluded from further analysis. All the patients (100%) in the GA group had pain at operated site
immediately after completion of operation and their pain score ranged from 4-7, all patients received rescue
analgesic before shifting to the ward. In the first 24h tramadol required as rescue in the GA group was 84±26
mg which was significantly higher than the SA group requiring only 31±32.18 mg. Although, the GA group had
more patients experiencing postoperative nausea & vomiting it was not statistically significant.
Conclusion: We concluded that laparoscopic cholecystectomy can be safely performed under spinal anaesthesia
using bupivacaine and clonidine as an adjuvant. Spinal anaesthesia provides stable intra-operative
haemodynamic and respiratory parameters, requires less postoperative analgesics with extended duration of
analgesia, with no major complications and has better patient satisfaction
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IJCPR,Vol15,Issue10,Article49.pdf
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Additional details
Dates
- Accepted
-
2023-08-15