Volume : VIII, Issue : II, February - 2019

A comparative study between Spinal vs General Anesthesia for Laparoscopic Cholecystectomy A randomized controlled trial

Kumar Sushil, Horo Veena

Abstract :

Cholecystectomy is one of the most commonly performed surgery in modern day surgical practice. While laparoscopic cholecystectomy has been well established as a gold standard for cholecystectomy surgery, there is ambiguity about the best method of anesthesia for laparoscopic cholecystectomy surgery. While General anesthesia is the preferred and accepted method for laparoscopic cholecystectomy surgery , spinal anesthesia with supplemental sedation is being very widely tried and found to be at least as satisfactory if not better than General Anesthesia . Plus the added advantages of cost effectiveness and better postoperative analgesia makes spinal anesthesia a very acceptable alternative to GA for lap cholecystectomy. We designed a staudy to compare spinal vs. General anesthesia in a controlled study and found spinal anesthesia to be better than GA for lap cholecystectomy. Objectives of study : To compare spinal anesthesia with the currently accepted gold standard technique i.e. general anesthesia for elective laparoscopic cholecystectomy. Setting: Medical College Hospital Design: Controlled randomized trial. Settings and Study design: One hundred patients with symptomatic gallstone disease and American Society of Anesthesiologists status I or II were randomized to have laparoscopic cholecystectomy under spinal (n=50) or general (n=50) anesthesia. Materials and Methods: Patients meeting inclusion criteria were randomised into two groups. Group A and Group B received general and spinal anaesthesia by standardised techniques. Both groups underwent standard four port laparoscopic cholecystectomy. Mean anaesthesia time and surgery time defined primary outcome measures. Intraoperative events and post operative pain score were secondary outcome measure. Intraoperative parameters, postoperative pain, complications, recovery, and patient satisfaction at follow up were compared between the 2 groups. Statistical Analysis Used : Student t test and chi square test Results : All the procedures were completed by the allocated method of anesthesia, as there were no conversions from spinal to general anesthesia. Pain was significantly less at 4 hours (P_.001), 8 hours (P_.001), 12 hours (P_.001), and 24 hours (P=.02) after the procedure for the spinal anesthesia group compared with those who received general anesthesia. There was no difference between the 2 groups regarding complications, hospital stay, recovery, or degree of satisfaction at follow-up. Conclusions : Spinal anesthesia is adequate and safe for laparoscopic cholecystectomy in otherwise healthy patients and offers better postoperative pain control than general anesthesia with similar recovery times and better patient satisfaction to some extent. Also, all the complications associated with general anesthesia can be avoided and conduct of anesthesia becomes safer.

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Article: Download PDF    DOI : https://www.doi.org/10.36106/gjra  

Cite This Article:

A COMPARATIVE STUDY BETWEEN SPINAL VS GENERAL ANESTHESIA FOR LAPAROSCOPIC CHOLECYSTECTOMY A RANDOMIZED CONTROLLED TRIAL, Kumar Sushil, Horo Veena GLOBAL JOURNAL FOR RESEARCH ANALYSIS : Volume-8 | Issue-2 | February-2019


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