Thoracic Spinal Anesthesia for Laparoscopic Cholecystectomy: An Observational Feasibility Study

Area of Science:

• Anesthesiology
• Regional Anesthesia
• Surgical Anesthesia

Background:

• Segmental Thoracic Spinal anesthesia is increasingly used in daily practice.
• The study aimed to assess its feasibility, safety, and complications in healthy patients.

Purpose of the Study:

• To determine the feasibility, safety, advantages, and complications of Segmental Thoracic Spinal anesthesia.
• To evaluate this anesthesia mode in healthy patients undergoing laparoscopic cholecystectomy.

Main Methods:

• Prospective observational study of 2,146 patients undergoing laparoscopic cholecystectomy.
• Exclusion criteria included ASA III/IV, severe comorbidities, beta-blocker use, coagulation issues, spinal deformities, or prior spine surgery.
• Subarachnoid block at T10-T11 with Bupivacaine Heavy and Dexmedetomidine was administered.

Main Results:

• Successful spinal anesthesia in 2,074 patients (97.1%), with 92% achieved in a single attempt.
• Intraoperative complications included paresthesia (5.8%), hypotension (18%), bradycardia (13%), nausea (10%), and shoulder tip pain (6%).
• No postoperative adverse events were reported, and 94% of patients were "very satisfied".

Conclusions:

• Thoracic spinal anesthesia is a feasible regional technique for healthy patients undergoing laparoscopic cholecystectomy.
• It offers manageable intraoperative hemodynamics with a low incidence of complications.
• The technique demonstrates no neurological complications and high patient satisfaction.