Laparoscopic cholecystectomy under spinal anesthesia

Laparoscopic Cholecystectomy Under Spinal Anaesthesia vs. General Anaesthesia: A Prospective Randomised Study

“…In the SA group, nine patients had diabetes mellitus which was well controlled and Although, recent studies have shown that laparoscopy in patients with regional anaesthesia may be tolerated well, shoulder tip pain can be a significant intraoperative problem. The reported incidence for intraoperative right-shoulder pain in previous studies requiring iv fentanyl administration ranged from 10 to 55.2% [6][7][8][9][10]. Referred pain to right shoulder is probably due to irritation of diaphragm by the CO 2 pneumoperitoneum [13].…”

“…Sinha et al, reported intraoperative right-shoulder pain in 12.3%patients but none of them required conversion to GA [8]. Yuksek et al, reported an incidence of intraoperative right-shoulder pain in 50%; it was severe enough to necessitate anaesthetic conversion in three patients (10.3%) and in five patients (17.2%), additional spraying of the diaphragm with 2% lidocaine solution was required for control of the pain [6]. Patients in SA group had lower pain scores in the first 24h, but after that the level of postoperative pain was similar in both groups.…”

“…Bessa et al, study had 22.2% of the GA group having PONV compared to only 6.9% of patients in the SA group. We inserted a nasogastric tube routinely in all our patients, but many studies have found that a nasogastric tube is not required in patients who have received SA [5][6][7]. Postoperative urinary retention requiring catheterisation was seen in two patients in the SA group.…”

“…SA has several advantages over GA, like reduced postoperative pain, nausea, vomiting and smooth post anesthesia recovery period, as the patient is awake and oriented at the end of procedure. There are multiple reports that have been published regarding the feasibility of SA for LC in patients fit for GA [4][5][6][7][8][9][10].…”

Spinal Anesthesia in Laparoscopic Cholecystectomy in a 75 Years Old Patient with Congestive Heart Failure NYHA III

“…We are all aware of the benefits of this procedure performed under laparoscopic approach. Advantages of LC such as less pain and short hospital stay make it the treatment of choice for cholelithiasis [1].…”