Spinal anaesthesia for laparoscopic cholecystectomy: a feasibility and safety study

Area of Science:

• Anesthesiology
• Surgical Procedures
• Patient Safety

Background:

• Regional anesthesia offers an alternative to general anesthesia (GA) for high-risk surgical patients.
• Spinal anesthesia (SA) is not routinely used as a sole anesthetic for laparoscopic cholecystectomy (LC).

Purpose of the Study:

• To evaluate the feasibility and safety of using SA as the sole anesthetic for LC.
• To assess patient outcomes and satisfaction with SA for LC.

Main Methods:

• Twelve patients with American Society of Anaesthesiologists physical status I or II underwent elective LC with SA using hyperbaric Bupivacaine and Morphine.
• Standardized per-operative management, CO2 pneumoperitoneum (intra-abdominal pressure <10 mm Hg), and minimal table tilt were employed.
• Per-operative events, operative difficulty, hospital stay, and patient satisfaction were monitored.

Main Results:

• SA was adequate for LC in 11 out of 12 patients.
• Minimal intraoperative interventions were required for pain, anxiety, or hypotension.
• Postoperative pain was minimal, with no opioid demand; 11 patients discharged within 48 hours.

Conclusions:

• SA combined with hyperbaric Bupivacaine and Morphine is adequate and safe for elective LC in healthy patients.
• This technique reduces postoperative pain and opioid requirements.
• Successful SA for LC requires patient education, a gentle surgical approach, and perioperative team collaboration.