Laparoscopic cholecystectomy under spinal-epidural anesthesia vs. general anaesthesia: a prospective randomised study

OpenAlex İngilizce

Purpose: Laparoscopic cholecystectomy (LC) is usually performed under the general anesthesia (GA).Aim of the study is to investigate the availability, safety and side effects of combined spinal/epidural anesthesia (CSEA) and comparison it with GA for LC.Methods: Forty-nine patients who have a LC plan were included into the study.The patients were randomly divided into GA (n = 25) and CSEA (n = 24) groups.Intraoperative and postoperative adverse events, postoperative pain levels were compared between groups.Results: Anesthesia procedures and surgeries for all patients were successfully completed.After the organization of pneumoperitoneum in CSEA group, 3 patients suffered from shoulder pain (12.5%) and 4 patients suffered from abdominal discomfort (16.6%).All these complaints were recovered with IV fentanyl administration.Only 1 patient developed hypotension which is recovered with fluid replacement and no need to use vasopressor treatment.Postoperative shoulder pain was significantly less observed in CSEA group (25% vs. 60%).Incidence of postoperative nausea and vomiting (PONV) was less observed in CSEA group but not statistically significant (4.2% vs. 20%).In the group of CSEA, 3 patients suffered from urinary retention (12.5%) and 2 patients suffered from spinal headache (8.3%).All postoperative pain parameters except 6th hour, were less observed in CSEA group, less VAS scores and less need to analgesic treatment in CSEA group comparing with GA group.Conclusion: CSEA can be used safely for laparoscopic cholecystectomies.Less postoperative surgical field pain, shoulder pain and PONV are the advantages of CSEA compared to GA.