Laparoscopic cholecystectomy under spinal anesthesia: comparative study between conventional-dose and low-dose hyperbaric bupivacaine

Imbelloni, Luiz Eduardo; Sant’Anna, Raphael; Fornasari, Marcos; Fialho, José Carlos

doi:10.2147/lra.s19979

Cited by 44 publications

(72 citation statements)

References 16 publications

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“…Comparison of side effects between groups. sensorial block were found to be shorter compare to higher dose used group which may be accepted as an advantage for this type of surgery 18 .…”

Section: Discussionmentioning

confidence: 70%

Comparison of General Anesthesia With Spinal Anesthesia In Laparoscopic Chlecystectomy Operations

KISA¹,

Koruk²,

Koçoğlu³

et al. 2019

MMJ

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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.

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“…Comparison of side effects between groups. sensorial block were found to be shorter compare to higher dose used group which may be accepted as an advantage for this type of surgery 18 .…”

Section: Discussionmentioning

confidence: 70%

Comparison of General Anesthesia With Spinal Anesthesia In Laparoscopic Chlecystectomy Operations

KISA¹,

Koruk²,

Koçoğlu³

et al. 2019

MMJ

View full text Add to dashboard Cite

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“…Recently, studying 646 patients submited to spinal thoracic anesthesia under a low approach confirmed the results of Jonnesco [2], in 1909, that thoracic spinal anesthesia is a viable procedure, with a low incidence of hypotension and did not present any neurologic problem [44].…”

Section: Advantages Of Thoracic Spinal Anesthesiamentioning

confidence: 72%

“…Other important point is the onset time with isobaric solution in the lumbar segment that is longer than with the hyperbaric solution. When the injection is given in the thoracic segment the difference is not significant between the solutions [44].…”

Section: Advantages Of Thoracic Spinal Anesthesiamentioning

confidence: 94%

“…The duration of motor and sensory block, incidence of hypotension and capability to move themselves to the transport cart (stretcher) were significantly shorter with the smaller dose and thoracic approach [44]. …”

Section: Advantages Of Thoracic Spinal Anesthesiamentioning

confidence: 97%

“…Comparing conventional dosis of hiperbaric bupivacaine and lumbar puncture with half the dose in the thoracic injection the onset time is reduced to reach T 3 [44] . The duration of motor and sensory block, incidence of hypotension and capability to move themselves to the transport cart (stretcher) were significantly shorter with the smaller dose and thoracic approach [44].…”

Section: Advantages Of Thoracic Spinal Anesthesiamentioning

confidence: 99%

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Thoracic Spinal Anesthesia

2016

JACCOA

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In 1909 Thomas Jonnesco published his interesting paper under the title General spinal anesthesia through an approach of the subarachnoid space at a thoracic level, providing condition for surgery on the skull, head, neck and thorax. Etherington-Wilson proposed explaining the various possibilities for the spinal anesthesia. Leonardo da Vinci was considered the discoverer of Human and animal Anatomy. Image techniques have opened a gret new field for the study of anatomy in the living man. The modern means of image, associated to computed means have facilitated the evaluation of the CSF volume, through antero-posterior and height measures of the subarachnoid space based on bi-dimentional studies of MRI. The studies of the thoracic column with MRI show that exist a space between the dura-mater and the spinal cord (medula). Thoracic ouncture performed with needles proved safe and without neurological injury. Thoracic spinal anesthesia is a viable procedure, with a low incidence of hypotension and did not present any neurologic problem.

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