A study on Evaluation of Clinical Efficacy, Feasibility and Safety of Laparoscopic Appendicectomy Under Spinal Anaesthesia Versus General Anaesthesia in a Tertiary Care Centre

Background: Laparoscopic appendicectomy (LA) is the gold standard surgical management for acute appendicitis. General anaesthesia (GA) has traditionally been the anaesthetic technique of choice for laparoscopic procedures. However, spinal anaesthesia (SA) is emerging as a cost-effective, safe, and feasible alternative, particularly in resource-constrained settings of tertiary care centres in developing nations. The haemodynamic profile, postoperative recovery, and analgesic requirements differ significantly between these two modalities. Objectives: To compare the clinical efficacy, feasibility, safety, intra-operative and postoperative adverse events, pain profiles (VAS), hospital stay, and patient satisfaction between laparoscopic appendicectomy performed under spinal versus general anaesthesia. Methods: This prospective, randomised comparative study was conducted at a tertiary care centre in North Bengal over a period of 12 months (January 2025–January 2026). A total of 63 patients diagnosed with acute or perforated appendicitis and scheduled for laparoscopic appendicectomy were enrolled. Patients were randomised into two groups: Group I (n=32) received spinal anaesthesia and Group II (n=31) received general anaesthesia. Demographic parameters, operative data, intra-operative and postoperative adverse events, Visual Analogue Scale (VAS) pain scores, hospital stay, and patient satisfaction were recorded and compared. Results: Both groups were comparable in terms of age, gender, BMI, and ASA grade. The total procedure time was significantly longer in Group I (SA: 68.7 min vs GA: 62.4 min, p=0.01). However, hospital stay was significantly shorter in the SA group (2.1 days vs 2.8 days, p=0.001). VAS pain scores were significantly lower in Group I at all measurement intervals (0h, 6h, 12h, 24h). Anxiety was the only intra-operative adverse event reaching statistical significance (SA 12.5% vs GA 0%, p=0.04). Postoperative complications were comparable between groups. Patient satisfaction was higher in Group I (90.6% vs 74.2%) though not statistically significant (p=0.08). Conclusion: Laparoscopic appendicectomy under spinal anaesthesia is a clinically efficacious, technically feasible, and safe alternative to general anaesthesia. It offers superior postoperative analgesia, shorter hospital stays, lower overall cost, and high patient satisfaction. SA should be considered a viable primary anaesthetic strategy, especially in tertiary care centres with resource limitations.