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Laparoscopic cholecystectomy under spinal anesthesia with nitrous oxide pneumoperitoneum: a feasibility study
M A Hamad1, O A Ibrahim El-Khattary
1Department of General Surgery, Assiut University Hospital, 71516 Assiut, Egypt. mostafa_hamad@yahoo.com
Surgical Endoscopy
|June 13, 2003
Summary
Laparoscopic cholecystectomy is feasible under spinal anesthesia. This study shows the procedure is well-tolerated, with minimal postoperative pain and vomiting, making it a viable option.
Area of Science:
- Surgical innovation
- Anesthesiology
- Minimally invasive surgery
Background:
- Spinal anesthesia is established for laparoscopic procedures.
- Laparoscopic cholecystectomy under spinal anesthesia remains undocumented.
- Investigating feasibility of this approach is crucial.
Purpose of the Study:
- To determine if laparoscopic cholecystectomy can be safely and effectively performed using spinal anesthesia.
- To assess patient tolerance and outcomes.
Main Methods:
- Ten laparoscopic cholecystectomies were performed under spinal anesthesia (T8-T6 level).
- Technique involved intrathecal hyperbaric bupivacaine (10-12 mg) with fentanyl (10 µg).
- Modifications included nitrous oxide insufflation, reduced intraabdominal pressure, altered trocar sites, and minimal manipulation.
Main Results:
- The procedure was well-tolerated by 9 out of 10 patients.
- Mean operative time was 47.4 minutes.
- One conversion to general anesthesia and one intraoperative emesis occurred; postoperative pain and vomiting were minimal.
Conclusions:
- Laparoscopic cholecystectomy is a feasible and well-tolerated procedure under spinal anesthesia.
- This technique offers a safe alternative with good patient outcomes.
- Further research may explore wider application.
