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High spinal nerve block for large bowel anastomosis. A prospective study
M H Worsley1, H Y Wishart, D A Peebles Brown
1Department of Anaesthesia, Western Infirmary, Glasgow.
British Journal of Anaesthesia
|June 1, 1988
Summary
Subarachnoid block anesthesia for large bowel surgery showed similar rates of anastomotic dehiscence compared to general anesthesia. However, spinal anesthesia significantly reduced blood loss and transfusion requirements.
Area of Science:
- Anesthesiology
- Surgical Outcomes
- Gastrointestinal Surgery
Background:
- Large bowel anastomosis is a critical surgical procedure.
- Anesthesia choice can impact surgical outcomes, including blood loss and complications.
- Conventional general anesthesia with mechanical ventilation is standard practice.
Purpose of the Study:
- To compare the incidence of anastomotic dehiscence between subarachnoid block with light general anesthesia and conventional general anesthesia.
- To evaluate differences in blood loss and transfusion requirements between the two anesthetic techniques.
Main Methods:
- A randomized, prospective study was conducted.
- 47 patients received subarachnoid block and light general anesthesia.
- 51 patients received conventional general anesthesia with intermittent positive pressure ventilation.
Main Results:
- Anastomotic dehiscence rates were similar: 17.0% in the spinal group and 17.6% in the general anesthesia group.
- Blood loss was significantly lower (P < 0.001) in the spinal anesthesia group.
- Blood transfusion was required in 10.6% of the spinal group versus 21.6% of the general anesthesia group.
Conclusions:
- Subarachnoid block with light general anesthesia is a viable alternative for large bowel anastomosis.
- This technique offers significant advantages in reducing blood loss and the need for blood transfusions.
- Anesthetic choice does not appear to influence the rate of anastomotic dehiscence in this patient population.