Comparison of Efficacy of Combined Spinal-Epidural Anaesthesia With General Anaesthesia in Patients Undergoing Laparoscopic Cholecystectomy

Abstract

Background:Initially general anaesthesia (GA) was considered the best suited technique for laparoscopic cholecystectomy (LC). Combined epidural with GA is considered for high risk cases but sole spinal/epidural anaesthesia is less popular due to some disadvantages. Given the significant benefits of regional anaesthesia over GA, the study aims to compare and evaluate the efficacy of combined spinal epidural anaesthesia (CSEA) and GA for LC. Methods: 60 ASA grade I and II patients scheduled for LC were arbitrarily divided into two groups comprising of 30 patients each based on anaesthesia technique i.e. GA and CSEA. In both groups systolic and diastolic blood pressure, heart rate, cardiovascular complications, hemodynamic changes, oxygen saturation, intraoperative and postoperative pain assessment, nausea and vomiting were recorded. Results: A significant difference in heart rate as well as intraoperative blood pressure was observed between GA and CSEA at various time intervals. The end tidal carbon dioxide values were not significantly different in two groups.(P<0.05) Postoperative VAS score and complications like nausea vomiting, incidence of shoulder pain, headache was more in patients of GA than in CSEA group which was statistically significant (P< 0.05). Conclusion: CSEA can be a safe and suitable method of anaesthesia in healthy ASA grade I-II patients. It provides better hemodynamic stability, offers better intra and post-operative pain control with less incidence of nausea vomiting in LC patients.