Feasibility of Laparoscopic Cholecystectomy Under Spinal Anaesthesia.

ABSTRACT

Laparoscopic Cholecystectomy (LC) has been conventionally done under general anaesthesia (GA). Regional anaesthesia is usually preferred in patients where GA is contraindicated. In this study, we present experience of using spinal anaesthesia (SA) for LC with the contention that it is a good alternative to GA. Spinal anaesthesia was used in 134 patients in whom LC was planned. There was no modification in the technique, and the intra abdominal pressure was kept at 8mm Hg to 12 mm Hg. Sedation was given if required, and conversion to GA was done in patients not responding to sedation or due to failure of SA. Results were compared with 100 patients who had undergone LC under GA. Out of 134 patients, two patients required conversion to GA. Hypotension requiring support was recorded in 28 (20.89%) patients, and 32 (23.88%) experienced neck or shoulder pain, or both. Postoperatively, 2.9% (4) of patients had vomiting as compared to 33% (33) of patients who were administered GA. Injectable diclofenac was required in 36.56% (49) for abdominal pain within 2 hours postoperatively and oral analgesic was required in 106 (79.10%) patients within the first 24 hours in SA group. However, 96% of patients operated under GA required injectable analgesics in the immediate postoperative period. Postural headache was experienced by 8 (5.9%) patients postoperatively. Average time of discharge was 1.9 days in patients operated under SA.