Laparo-endoscopic single-site (LESS) cholecystectomy with epidural vs. general anesthesia

Ross, Sharona; Mangar, Devanand; Karlnoski, Rachel; Camporesi, Enrico; Downes, Katheryne; Luberice, Kenneth; Haines, Krista; Rosemurgy, Alexander S.

doi:10.1007/s00464-012-2667-8

Cited by 20 publications

(22 citation statements)

References 30 publications

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“…The change in EtCO 2 after irrigation was not significant when compared between or within the cohorts. Ross et al (13) reconfirmed that epidural anesthesia for laparoscopy does not cause ventilator depression. The PaCO 2 has been reported to increase after CO 2 pneumoperitoneum for spontaneously breathing patients.…”

Section: Dmentioning

confidence: 98%

“…Ross et al (13) found that PaCO 2 levels were significantly higher with epidural anesthesia compared with general anesthesia at the time of incision (43.8 versus 29.7) and 5 min after insufflation (44.8 versus 31.8) but not after closure. Before irrigation of the diaphragm with local anesthetic, the average EtCO 2 was 35.9 ± 2.1 in the general anesthesia cohort and 34.0 ± 12.6 in the epidural cohort.…”

Section: Dmentioning

confidence: 99%

“…Agrawal et al (15) found that SaO 2 remained within 95%-99% during thoracic epidural anesthesia for laparoscopic cholecystectomy. Ross et al (13) found that SaO 2 was significantly higher in the general anesthesia cohort compared with the epidural cohort at incision (99.7 versus 98.4, p = 0.002) and closure (99.7 versus 98.6, p = 0.001) during LESS cholecystectomy under epidural versus general anesthesia.…”

Section: Cmentioning

confidence: 99%

“…Kim et al (3) found severe hypotension and bradycardia due to an abrupt increase in intraabdominal pressure in a case of thoracic epidural anesthesia for laparoscopic cholecystectomy in an elderly patient with severely impaired pulmonary function tests. Ross et al (13) found that 1 patient (10%) from 10 patients in the general anesthesia cohort experienced bradycardia and hypotension at the start of insufflation.…”

Section: Bmentioning

confidence: 99%

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Laparoscopic Cholecystectomy Under Thoracic Epidural Anesthesia in Comparison With General Anesthesia

Durgham

Ahmad

Zakzouk

2014

Zagazig University Medical Journal

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Background: Regional anesthesia for laparoscopic cholecystectomy (LC) is considered to have some advantages compared with general anesthesia. Patients can be awake and oriented at the end of the surgery and have less postoperative pain, nausea and vomiting. Problems related to general anesthesia such as oral and teeth injury during laryngoscopy, and a sore throat and stomach inflation as a result of mask ventilation might be avoided in a regional anesthetic setting. Objective: the aim of the study is to compare between thoracic epidural anesthesia (TEA) and general anesthesia (GA) for LC regarding intraoperative hemodynamics, postoperative analgesia and cost. Patients and methods: 116 patients undergoing elective laparoscopic cholecystectomy surgery in general surgery department in Zagazig University hospitals were randomly divided into two groups. Group A received GA with 1-2 µg/kg fentanyl, 2 mg/kg propofol, 0.5 mg/kg cis-tracrium and isoflurane 2 MAC. Group B received 15 ml bupivacaine 0.5% with 70-100 µg fentanyl in thoracic epidural catheter inserted at T 10-11 interspace. Both groups were given 30 ml bupivacaine 0.375% intraperitoneal infradiaphragmatic after insertion of the trocar and insufflations of the peritoneal cavity before starting surgery. Results: TEA proved to be having lower incidence of postoperative shoulder pain, postoperative nausea and vomiting (PONV) and lower cost than GA and a higher incidence of patient and surgeon satisfaction, hypotension and bradycardia. Conclusion: TEA may be a good alternative to GA for LC.

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Section: Dmentioning

confidence: 98%

Section: Dmentioning

confidence: 99%

Section: Cmentioning

confidence: 99%

Section: Bmentioning

confidence: 99%

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Laparoscopic Cholecystectomy Under Thoracic Epidural Anesthesia in Comparison With General Anesthesia

Durgham

Ahmad

Zakzouk

2014

Zagazig University Medical Journal

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“…Considering the successful use for laparoscopic cholecystectomy under epidural anesthesia and the advantages of epidural anesthesia. [1][2][3][4][5] We choose the thoracic epidural anesthesia alone for the patient undertaking the gas-free transumbilical single port laparoscopic cholecystectomy initially. But we can learn from our case that one of the most important problems of this surgery under thoracic epidural anesthesia is inadequate relaxation of abdominal musculature, in addition, gas-free trans-umbilical single port laparoscopic cholecystectomy is an immature technique, which need resolve it by combining with laryngeal mask intubation.…”

Section: Discussionmentioning

confidence: 99%

Thoracic epidural anesthesia for gas-free trans-umbilical single port laparoscopic cholecystectomy: a case report

Zhao

et al. 2016

Int Surg J

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Laparoscopic cholecystectomy (LC) is usually performed under general anaesthesia (GA). With the advancement of surgical and anaesthetic technique, there were many LC have been successfully performed under epidural anaesthesia in recent years. Surgeons in our hospital have performed gas-free trans-umbilical single port laparoscopic cholecystectomy since 2015. However, the description of thoracic spinal epidural anesthesia (TEA) for gas-free trans-umbilical single port laparoscopic cholecystectomy has not been reported yet. The goal of anesthetic management in gas-free trans-umbilical single port laparoscopic cholecystectomy procedures includes achieving an adequate level of sensory blockade without any respiratory compromise, providing good postoperative pain relief, and mild pain at early ambulation. Epidural anaesthesia fulfils all the mentioned criteria and can contribute to quick recovery and thus has been suggested to be a suitable alternative to general anaesthesia for laparoscopic surgeries. We present a case of the successful application of the thoracic epidural anaesthesia combined with laryngeal mask for gas-free trans-umbilical single port laparoscopic cholecystectomy and postoperative pain.

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Transanal Endoscopic Operation under spinal anaesthesia

Arezzo

Cortese

Arolfo

et al. 2016

British Journal of Surgery

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Laparo-endoscopic single-site (LESS) cholecystectomy with epidural vs. general anesthesia

Abstract: LESS cholecystectomy with epidural anesthesia was completed with no operative or anesthetic conversions, and less postoperative pain at discharge. Epidural anesthesia appears to be a preferable alternative to general anesthesia for patients undergoing LESS cholecystectomy.

Cited by 20 publications

References 30 publications

Laparoscopic Cholecystectomy Under Thoracic Epidural Anesthesia in Comparison With General Anesthesia

Laparoscopic Cholecystectomy Under Thoracic Epidural Anesthesia in Comparison With General Anesthesia

Thoracic epidural anesthesia for gas-free trans-umbilical single port laparoscopic cholecystectomy: a case report

Transanal Endoscopic Operation under spinal anaesthesia

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