Spinal anaesthesia for laparoscopic cholecystectomy: A comparison with general anaesthesia regarding haemodynamic and respiratory stability

Abstract

General anaesthesia has been technique of choice for laparoscopic surgeries. Given the advantages of spinal anaesthesia, we conducted a study to see feasibility of spinal anaesthesia in laparoscopic cholecystectomy in respect to cardiovascular and respiratory stability and post operative outcome. After obtaining institutional ethical committee approval, sixty consenting patients for laparoscopic cholecystectomy were randomized into two groups to receive spinal or general anaesthesia. Spinal anaesthesia was given with 0.5% bupivacaine heavy and 1µg/kg clonidine. General anaesthesia group received standard general anaesthesia with endotracheal intubation and positive pressure ventilation. Intraoperative haemodynamics, end tidal and arterial CO2, postoperative analgesia, satisfaction scores and complications were compared. As per Student t test and Chi square tests demographic, surgical duration, haemodynamic parameters were comparable. Perioperative PaCO2 was stable and comparable. 24 hr visual analog pain scores, tramadol consumption were significantly less in spinal group. Incidence of postoperative nausea and shoulder tip pain was less than 6% in spinal group. Both groups had good patient and surgeon acceptance. Conclusion: Laparoscopic cholecystectomy can be safely performed under spinal anesthesia and provides good hemodynamic and respiratory stability, requires less postoperative analgesia and better patient and surgeon satisfaction.