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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

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A

|June 13, 2012

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.

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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.