Laparoscopic Cholecystectomy Under Spinal Anaesthesia vs. General Anaesthesia: A Prospective Randomised Study

Area of Science:

• Anesthesiology
• Surgical Innovation
• Gastrointestinal Surgery

Background:

• Laparoscopic cholecystectomy (LC) is typically performed under general anesthesia (GA).
• Spinal anesthesia (SA) has emerged as a potential safe alternative.
• This study evaluates SA for LC compared to GA.

Purpose of the Study:

• To assess the safety and feasibility of LC under spinal anesthesia.
• To compare SA with GA for LC in terms of patient outcomes.
• To determine the cost-effectiveness of SA for LC.

Main Methods:

• Fifty patients with symptomatic gallstones (ASA I/II) were randomized to LC under SA (n=25) or GA (n=25).
• Intraoperative vitals, postoperative pain, complications, recovery, and surgeon satisfaction were compared.
• Rescue analgesic use and pain scores were key outcome measures.

Main Results:

• SA group: 24% experienced shoulder pain, 8% required conversion to GA. No immediate postoperative pain at the operative site.
• GA group: 100% had immediate postoperative pain (scores 4-7), requiring significant rescue analgesia (82±24 mg tramadol in 24h).
• SA group required significantly less rescue analgesia (30±33.16 mg tramadol in 24h) with minimal postoperative pain.

Conclusions:

• Spinal anesthesia is a feasible and safe sole anesthetic technique for elective laparoscopic cholecystectomy.
• SA offers significant advantages in reducing postoperative pain and analgesic consumption compared to GA.
• SA presents a cost-effective alternative for elective LC.