Comparative Study of Segmental Thoracic Spinal Versus Thoracic Epidural Anesthesia for Laparoscopic Cholecystectomy

Moutaz, Hatem El; Wahab, Hazem Abdel; Ghany, Jehan Mohammed Mohammed Abdel

doi:10.24087/iam.2018.2.12.730

Cited by 5 publications

(4 citation statements)

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“…In this study, there was no paresthesia in either group. That was in agreement with other studies (Elakany and Abdelhamid 2013 ), (El Moutaz et al 2018 ). Van Zundert et al reported an incidence of 5% paresthesia but during combined spinal-epidural (Tuohy) needle insertion.…”

Section: Discussionsupporting

confidence: 94%

Comparison between thoracic paravertebral block and segmental thoracic spinal anesthesia in breast cancer surgery

Mazy

El-Domiaty

Mageed

et al. 2022

Ain-Shams J Anesthesiol

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Background Thoracic paravertebral block (TPVB) and segmental thoracic spinal anesthesia (STSA) can be used as sole anesthesia techniques alternative to general anesthesia for modified radical mastectomy in some critical patients. Both techniques were compared for efficacy and safety including detailed block characteristics, analgesia, patient’s and surgeon’s satisfaction, hemodynamics, respiration, and side effects. Results Both techniques were successful, but fentanyl requirements were higher in TPVB group. The sensory loss was faster, wider, and longer in STSA group; however, it was associated with more hypotension. There was no motor block in the upper or lower limbs in TPVB group, while all patients in STSA group showed ipsilateral handgrip affection and to less extent wrists and then elbow flexion. While the ipsilateral lower limbs motor block was partial and short. Postoperatively, there was no difference in analgesic requirements or side effects. Satisfaction was higher in STSA group. Conclusions Both TPVB and STSA were effective and safe as sole techniques for mastectomy providing adequate anesthesia with low complications, considerable analgesia, and satisfaction. Anesthesia was faster, wider, and longer in STSA group, with lower fentanyl requirements; however, it was associated with more hypotension.

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Section: Discussionsupporting

confidence: 94%

Comparison between thoracic paravertebral block and segmental thoracic spinal anesthesia in breast cancer surgery

Mazy

El-Domiaty

Mageed

et al. 2022

Ain-Shams J Anesthesiol

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“…El Moutaz et al compared segmental spinal thoracic anesthesia with thoracic epidural anesthesia in 35 patients undergoing laparoscopic cholecystectomies. They found that the spinal group had better surgeon satisfaction scores [16]. Vincenzi et al found thoracic segmental spinal anesthesia at T6-T8 levels in four patients who had undergone unilateral mastectomy ± axillary dissection ± sentinel lymph node biopsy.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Observational Study on the Effectiveness of Segmental Spinal Anesthesia in Patients Posted for Modified Radical Mastectomies

2023

Ann Case Report

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Background: Modified radical mastectomy is a treatment of choice in patients having carcinoma breast. The higher chances of complications with general anesthesia lead to a change in our clinical practice towards regional anesthesia. The current literature revealed that the maximum distance between the dura mater and the spinal cord is at the mid-thoracic level, but very few studies are advocating for the use of segmental spinal anesthesia for modified radical mastectomies. Therefore, the present study is planned to assess the effectiveness of segmental spinal anesthesia in patients posted for modified radical mastectomies. Material and Methods:The present study was conducted at a tertiary care centre between April 2020 to November 2022 after approval by the institute's ethical and research committee. The study recruited 78 patients aged between 20-70 years with American Society of Anesthesiologists (ASA) physical status I-III who were scheduled for modified radical mastectomy with axillary dissection. A subarachnoid block was performed at T5-T6 or T6-T7 levels with 27 G Quincke Babcock needle using a midline approach with a 45° tilt of the needle in all the patients under aseptic precautions after. Once the free flow of Cerebrospinal fluid (CSF) was confirmed, 1.5 ml isobaric levobupivacaine with 5 mcg of Dexmedetomidine was administered. Results:In the present study, 97% of the surgeons were satisfied with the procedure. All the patients had stable hemodynamics and adequate sensory and motor blockade. A single episode of hypotension was noted in 9% percent of the patients and 6% of them had bradycardia once during the procedure. However, the alterations in hemodynamics were successfully managed during the procedure. Paresthesia was found during needle insertion in 4% of patients, but none of them had any neurological damage. Conclusion:Segmental spinal anesthesia is a safe alternative to general anesthesia in cases of carcinoma breast undergoing modified radical mastectomy.

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“…conducted a study with 20 patients, implementing a very similar anesthesia technique. Their results indicated that STSA can be effectively employed for laparoscopic surgeries in additional healthy subjects [27]. These collective findings shed light on the potential application and effectiveness of thoracic spinal anesthesia in various patient populations, offering promising prospects for laparoscopic procedures.…”

Section: Safety Of Thoracic Spinal Anesthesia For Laparoscopic Cholec...mentioning

confidence: 83%

Role of Thoracic Spinal Anesthesia in Laparoscopic Cholecystectomy: A Literature Review

Mohsen¹

2023

JAMMR

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The efficacy of thoracic spinal anesthesia (TSA) in laparoscopic cholecystectomy has been investigated through various studies focusing on patient satisfaction, pain management, and safety. In comparison to general anesthesia, Thoracic spinal anesthesia (TSA) in laparoscopic cholecystectomy was associated with shorter discharge times and greater patient satisfaction compared to general anesthesia. However, it should be noted that surgeon satisfaction was higher with general anesthesia. TSA demonstrated superior postoperative analgesia and hemodynamic stability compared to lumbar spinal anesthesia, making it a safe and effective alternative for laparoscopic cholecystectomy in healthy patients. Additionally, segmental thoracic spinal anesthesia was found to be associated with a lower incidence of postoperative pneumonia and atelectasis, making it a preferable choice for patients with respiratory comorbidities. Overall, thoracic spinal anesthesia showed promising outcomes, manageable intraoperative complications, and high patient satisfaction rates, making it a feasible regional anesthesia technique for laparoscopic cholecystectomy.

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Comparative Study of Segmental Thoracic Spinal Versus Thoracic Epidural Anesthesia for Laparoscopic Cholecystectomy

Cited by 5 publications

References 0 publications

Comparison between thoracic paravertebral block and segmental thoracic spinal anesthesia in breast cancer surgery

Comparison between thoracic paravertebral block and segmental thoracic spinal anesthesia in breast cancer surgery

A Prospective Observational Study on the Effectiveness of Segmental Spinal Anesthesia in Patients Posted for Modified Radical Mastectomies

Role of Thoracic Spinal Anesthesia in Laparoscopic Cholecystectomy: A Literature Review

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