Combined spinal-epidural anesthesia in laparoscopic appendectomy: a prospective feasibility study.
10.4174/astr.2017.92.4.208
- Author:
Sinan UZMAN
1
;
Turgut DONMEZ
;
Vuslat Muslu ERDEM
;
Adnan HUT
;
Dogan YILDIRIM
;
Muzaffer AKINCI
Author Information
1. Department of Anesthesiology and Reanimation, Haseki Training and Research Hospital, Istanbul, Turkey. drsinanuzman@yahoo.com
- Publication Type:Original Article
- Keywords:
Laparoscopy;
Spinal anesthesia;
Epidural anesthesia;
Appendicitis
- MeSH:
Anesthesia*;
Anesthesia, Conduction;
Anesthesia, Epidural;
Anesthesia, Spinal;
Anxiety;
Appendectomy*;
Appendicitis;
Classification;
Feasibility Studies*;
Headache;
Humans;
Hypotension;
Laparoscopy;
Pain, Postoperative;
Patient Satisfaction;
Postoperative Nausea and Vomiting;
Prospective Studies*;
Shoulder Pain;
Urinary Retention
- From:Annals of Surgical Treatment and Research
2017;92(4):208-213
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Laparoscopic appendectomy (LA) is routinely performed under general, not regional anesthesia. This study assessed the feasibility, efficacy, and side effects of combined spinal-epidural anesthesia (CSEA) in LA. METHODS: Thirty-three American Society of Anesthesiologist (ASA) physical status classification grade I patients underwent LA under CSEA. CSEA was performed using the needle-through-needle technique at the L₃–L₄ interspace. Preoperative and postoperative adverse events related to CSEA, patient satisfaction, and postoperative pain levels were recorded. RESULTS: LA under CSEA was performed successfully in 33 patients (84.6%). Peroperatively, right shoulder pain was observed in 8 patients (24.1%), abdominal discomfort in 6 (18.2%), anxiety in 5 (15.2%), hypotension in 2 (6.1%) and nausea-vomiting in 1 (3%). In the first 24 hours after LA, headache, urinary retention, right shoulder pain, and postoperative nausea/vomiting (PONV) occurred in 18.1%, 12.1%, 9.1%, and 0% of patients, respectively. In the first 6 hours postoperation, no patients had operation-site pain that required analgesic treatment. Thirty-one patients (94%) evaluated their satisfaction with the procedure as good or moderate. CONCLUSION: CSEA is an efficient and suitable anesthesia technique in LA for ASA physical status classification grade I healthy patients. CSEA is associated with good postoperative pain control and the absence of PONV and intubation-associated complications.
