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Spinal versus general anesthesia for day-case laparoscopic cholecystectomy: a prospective randomized study
Samer S Bessa1, Khaled M Katri, Wael N Abdel-Salam
1Department of General Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt. samerbessa@gmail.com
Summary
Day-case laparoscopic cholecystectomy under spinal anesthesia is safe and effective for gallstone disease. It offers reduced pain, nausea, and fewer overnight stays compared to general anesthesia.
Area of Science:
- Surgical outcomes
- Anesthesiology
- Gastroenterology
Background:
- Symptomatic uncomplicated gallstone disease management.
- Day-case laparoscopic cholecystectomy (DCLC) is a common surgical procedure.
- Anesthesia choice impacts surgical outcomes and patient experience.
Purpose of the Study:
- Compare surgical outcomes of DCLC under spinal anesthesia versus general anesthesia.
- Evaluate feasibility, safety, and patient satisfaction.
- Assess postoperative complications and length of stay.
Main Methods:
- 180 patients prospectively randomized to spinal anesthesia DCLC (SA-DCLC) or general anesthesia DCLC (GA-DCLC).
- Recorded intraoperative events, postoperative complications, pain scores, overnight stays, and readmissions.
- Assessed patient satisfaction via questionnaire.
Main Results:
- All procedures completed laparoscopically; 4.4% anesthetic conversions in SA-DCLC group.
- 100% same-day discharge in SA-DCLC group vs. 8.9% overnight stay in GA-DCLC group (P<.001).
- Overnight stays in GA-DCLC group due to nausea, vomiting, pain, or hypotension; 1.1% readmission.
Conclusions:
- Spinal anesthesia DCLC is feasible and safe for gallstone disease.
- SA-DCLC associated with less postoperative pain and lower incidence of nausea and vomiting.
- SA-DCLC leads to a lower incidence of overnight stay compared to GA-DCLC.
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