Open Appendicectomy under Spinal Anesthesia-A Valuable Alternative during COVID-19

Area of Science:

• Anesthesiology
• Surgical Innovation
• Infectious Disease Preparedness

Background:

• Concerns regarding aerosolization during general anesthesia (GA) for appendicitis surgery.
• Spinal anesthesia (SA) for open appendicectomy is uncommon in the UK but standard in developing nations.
• Need for alternative anesthetic techniques during the COVID-19 pandemic.

Purpose of the Study:

• To present the first United Kingdom case series of open appendicectomy under SA.
• To evaluate the safety, feasibility, and patient satisfaction of this technique.
• To discuss its potential role during and after the COVID-19 pandemic.

Main Methods:

• Prospective study of patients undergoing open appendicectomy under SA for appendicitis.
• Study conducted at a British district general hospital over 5 weeks.
• Assessment of 30-day complication rates and patient satisfaction.

Main Results:

• Seven patients included, none COVID-19 positive.
• No major postoperative complications (Clavien-Dindo grade III-V).
• High patient satisfaction (five-sevenths) despite some preferring GA in hindsight.

Conclusions:

• Open appendicectomy under SA is safe and feasible in the UK.
• The technique is a valuable contingency for COVID-suspected cases and high-risk respiratory patients.
• Further evaluation of contraindications and specific complications is warranted.