Laparoscopic cholecystectomy under spinal-epidural anesthesia vs. general anaesthesia: a prospective randomised study.
10.4174/astr.2017.92.3.136
- Author:
Turgut DONMEZ
1
;
Vuslat Muslu ERDEM
;
Sinan UZMAN
;
Dogan YILDIRIM
;
Huseyin AVAROGLU
;
Sina FERAHMAN
;
Oguzhan SUNAMAK
Author Information
1. Department of General Surgery, Lutfiye Nuri Burat State Hospital, Istanbul, Turkey. surgeont73@hotmail.com
- Publication Type:Original Article
- Keywords:
Laparoscopic cholecystectomy;
General anesthesia;
Epidural anesthesia;
Spinal anesthesia
- MeSH:
Anesthesia*;
Anesthesia, Epidural;
Anesthesia, General;
Anesthesia, Spinal;
Cholecystectomy, Laparoscopic*;
Fentanyl;
Headache;
Humans;
Hypotension;
Incidence;
Pain, Postoperative;
Pneumoperitoneum;
Postoperative Nausea and Vomiting;
Prospective Studies*;
Shoulder Pain;
Urinary Retention
- From:Annals of Surgical Treatment and Research
2017;92(3):136-142
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Laparoscopic cholecystectomy (LC) is usually performed under the general anesthesia (GA). Aim of the study is to investigate the availability, safety and side effects of combined spinal/epidural anesthesia (CSEA) and comparison it with GA for LC. METHODS: Forty-nine patients who have a LC plan were included into the study. The patients were randomly divided into GA (n = 25) and CSEA (n = 24) groups. Intraoperative and postoperative adverse events, postoperative pain levels were compared between groups. RESULTS: Anesthesia procedures and surgeries for all patients were successfully completed. After the organization of pneumoperitoneum in CSEA group, 3 patients suffered from shoulder pain (12.5%) and 4 patients suffered from abdominal discomfort (16.6%). All these complaints were recovered with IV fentanyl administration. Only 1 patient developed hypotension which is recovered with fluid replacement and no need to use vasopressor treatment. Postoperative shoulder pain was significantly less observed in CSEA group (25% vs. 60%). Incidence of postoperative nausea and vomiting (PONV) was less observed in CSEA group but not statistically significant (4.2% vs. 20%). In the group of CSEA, 3 patients suffered from urinary retention (12.5%) and 2 patients suffered from spinal headache (8.3%). All postoperative pain parameters except 6th hour, were less observed in CSEA group, less VAS scores and less need to analgesic treatment in CSEA group comparing with GA group. CONCLUSION: CSEA can be used safely for laparoscopic cholecystectomies. Less postoperative surgical field pain, shoulder pain and PONV are the advantages of CSEA compared to GA.
