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Laparoscopic appendectomy under spinal anesthesia with dexmedetomidine infusion
Go-Woon Jun1, Min-Su Kim1, Hun-Ju Yang1
1Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
Korean Journal of Anesthesiology
|November 5, 2014
Summary
Spinal anesthesia with dexmedetomidine infusion shows feasibility for laparoscopic appendectomy (LA). While effective, supplemental analgesia and monitoring for bradycardia are crucial for successful outcomes in this minimally invasive surgery.
Area of Science:
- Anesthesiology
- Surgical Innovation
Background:
- Laparoscopic appendectomy (LA) is infrequently performed under regional anesthesia due to pneumoperitoneum challenges.
- Dexmedetomidine was investigated for its potential to mitigate issues associated with spinal anesthesia alone during LA.
Purpose of the Study:
- To assess the feasibility of using spinal anesthesia combined with intravenous dexmedetomidine infusion for laparoscopic appendectomy.
Main Methods:
- A feasibility study involving 26 patients undergoing LA with spinal anesthesia and continuous intravenous dexmedetomidine infusion.
- Supplemental analgesia (fentanyl or ketamine) was administered as needed for pain or discomfort.
- Adverse effects, including bradycardia, were systematically evaluated.
Main Results:
- All 26 procedures were successfully completed laparoscopically without conversion to open surgery or general anesthesia.
- Supplemental analgesia was required in 17 patients (65.4%).
- Bradycardia was observed in 7 patients (26.9%).
Conclusions:
- Spinal anesthesia with dexmedetomidine infusion appears feasible for laparoscopic appendectomy.
- The technique necessitates careful management of supplemental analgesia and sedation.
- Vigilant monitoring for bradycardia is essential for patient safety.
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