Comparison of General Anesthesia With Spinal Anesthesia In Laparoscopic Chlecystectomy Operations

Abstract

Objective: Laparoscopic cholecystectomy (LC) operations are being performed under general anesthesia (GA). Further studies are needed on the issue whether these operations can be performed under spinal anesthesia (SA). In this study we aimed to compare SA with (GA) in terms of efficacy and complications in patients who will undergo LC operations, and to investigate the effects of preemptive analgesia on the development of shoulder pain, transition to general anesthesia, and postoperative analgesia. Method: Sixty patients in ASA I-II risk group between 18-65 years of age undergoing laparoscopic cholecystectomy were randomly divided into general anesthesia (GA, n=30) and spinal anesthesia (SA, n=30) groups. Patients were premedicated with i.v. midazolam and fentanyl preoperatively. Anesthesia was induced with propofol in the GA group, and maintained with Desflurane and remifentanil. In the SA group, spinal anesthesia was provided with intratechal administration of 15 mg bupivacaine at L2-3 level, and block level was increased to T4 by keeping the patient in Trendelenburg position for 7-10 minutes. Demographic data, hemodynamic parameters, operation time, visual analog scale (VAS) scores at postoperative 0 th ,1 st , 4 th , 8 th ,12 th and 24 th hours, patient-surgeon satisfaction, side effects, and occurrence of right shoulder pain in SA group were inquired and recorded. Results: Effective anesthesia was produced in both groups. Hypotension was observed in 5, bradycardia requiring atropin administration in 4, and perioperative shoulder pain in 9 patients in Group SA, but none of them required general anesthesia. Hypotension developed in one patient in Group GA. The postoperative VAS scores were significantly lower in Group SA at 0 th ,1 st , 4 th hours. Patient satisfection scores were higher in Group SA. Conclusion: We concluded that spinal anesthesia may be an alternative method to general anesthesia in patients who will undergo laparoscopic cholecystectomy operations especially when the risk of general anesthesia is too high.

Anesthesia Effect of Remifentanil Combined with Propofol in Laparoscopic Cholecystectomy and Its Impact on Postoperative Cognitive Recovery

“…Remifentanil belongs to the current new type of opioid receptor agonist, with short action time, rapid onset of action, rapid recovery, and strong controllability. Also, the anesthesia drugs are eliminated faster in patients using remifentanil combined with propofol, which minimizes the impact of anesthetic drugs on the cognitive function and state of consciousness [21].…”

Spontaneous hyperinflation of a giant bulla of the non-ventilated lung during laparoscopic cholecystectomy under one-lung ventilation: a case report

“…Intubating a single-lumen tube and placing a bronchial blocker in the right intermediate bronchus may enable ventilation of the right upper lobe and left lung while preventing PPV of the giant bulla. Although laparoscopic cholecystectomy is typically performed under general anesthesia and PPV, recent studies have shown that it can be performed safely under neuraxial block and spontaneous breathing [ 7 , 8 ]. Spinal anesthesia or combined spinal and epidural anesthesia with spontaneous breathing may have been a good alternative in our case.…”

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

“…These findings make SA an ideal technique for elective laparoscopic surgeries performed on low-risk patients with an American Society of Anesthesiologists (ASA) score of 1 or 2. SA not only facilitates faster patient recovery but also enables early discharge, ultimately leading to reduced costs [5][6][7][8][9].…”