Spinal Anaesthesia for Laparoscopic Cholecystectomy: An Emerging Trend in Minimally Invasive Surgery

Background: Laparoscopic cholecystectomy is conventionally performed under general anaesthesia; however, growing interest in enhanced recovery protocols has renewed attention toward regional anesthetic techniques. Spinal anesthesia has become a viable option, with benefits such as decreased postoperative morbidity, expedited recovery, and enhanced patient satisfaction.

Aim: The primary aim of this study was to explore the feasibility of safety, and perioperative results of spinal anesthesia in patients undergoing elective laparoscopic cholecystectomy.

Materials & Methods: This prospective observational study encompassed 60 adult patients (ASA physical status I-II) designated for elective laparoscopic cholecystectomy. A low-dose intrathecal local anesthetic approach was employed to achieve spinal anesthesia, aiming for a sensory block level between T4 and T6. Key intraoperative parameters included characteristics of the neuraxial block, changes in blood flow, shoulder tip pain, the need for more painkillers, and the switch to general anesthesia. The postoperative outcomes examined encompassed pain levels, recovery milestones, complications, duration of hospital stay, and patient satisfaction. Data was examined descriptively with suitable statistical methodologies.

Results: All patients indicated acceptable sensory block, with a mean onset time of 6.2 ± 1.4 minutes. In 10.0% and 23.3% of patients, bradycardia and intraoperative hypotension were treated conservatively. Shoulder tip pain was reported in 15.0% of cases, and conversion to general anaesthesia was required in 3.3%. Early ambulation and oral intake, low pain scores, limited nausea and vomiting, and a quick hospital stay of 1.3 ± 0.5 days facilitated a rapid postoperative recovery. Patients were quite happy, with 86.7% saying they would prefer spinal anesthesia again.

Conclusion: For certain patients undergoing laparoscopic cholecystectomy, spinal anaesthesia may serve as a safe and effective alternative to general anesthesia. It is linked to higher rates of recovery after surgery and stability throughout surgerya