Laparoscopic cholecystectomy under spinal-epidural anesthesia vs. general anaesthesia : a prospective randomised study :a prospective randomised study

Turgut Donmez; Vuslat Muslu Erdem; Sinan Uzman; Dogan Yildirim; Huseyin Avaroglu; Sina Ferahman; Oguzhan Sunamak

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저자정보: Turgut Donmez (Lutfiye Nuri Burat State Hospital) Vuslat Muslu Erdem (Lutfiye Nuri Burat Goverment Hospital) Sinan Uzman (Haseki Training and Research Hospital) Dogan Yildirim (Haseki Training and Research Hospital) Huseyin Avaroglu (Lutfiye Nuri Burat State Hospital) Sina Ferahman (Istanbul University) Oguzhan Sunamak (Haydapasa Numune Training and Research Hospital)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.92 No.3

발행연도: 2017.3

수록면: 136 - 142 (7page)

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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.

#Laparoscopic cholecystectomy #General anesthesia #Epidural anesthesia #Spinal anesthesia

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