Efficacy of Spinal Anaesthesia as a Safer Technique in Laparoscopic Cholecystectomy with Better Outcome
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 10
Abstract
Spinal anaesthesia is always a safe, cost effective and a better option in patients where general anaesthesia can be complicated and to fulfill the purpose of postoperative analgesia. After conducting many upper abdominal surgeries and open cholecystectomy under spinal anaesthesia, this study was conducted on single, three and conventional four port laparoscopic cholecystectomy under spinal anaesthesia to assess its efficacy, safety, reliability and as an alternative to general anaesthesia with minimum risk. This study was conducted on 300 patients of either sex belonging to ASAI & II, age 2070 years admitted for planned laparoscopic cholecystectomy. Bupivacaine (2.5 to 4ml) was injected indurally in lateral position at the level of L2. Dose of bupivacaine varied according to the feasibility and compatibility of the operating surgeon. Pneumoperitoneum with CO2 was created with the range of 1014mmHg intraabdominal pressure, according to the ease of the surgeon,at the rate of 1 L/min. Patients were sedated with Inj pentazocine 30mg and midazolam 2mg/diazepam 10mg intravenously after performing spinal anaesthesia. Any discomfort and intensity to the patient due to right shoulder pain was observed and managed accordingly from right shoulder massage to supplementation with propofol 1mg/kg. No patient was converted into general anaesthesia with tracheal intubation. Mean age was 41.7 years. Mean surgical duration was 53.19±12.55 min. Mean duration of sensory block was 157.39±23.47 min and mean duration of motor block was 134.17±19.52 min. Laparoscopic cholecystectomy can be performed under spinal anaesthesia with better outcome and safety without having any major complication.
Authors and Affiliations
Ajai Vikram Singh
Keywords
Related Articles
- EP ID EP549027
- DOI 10.21088/ijaa.2349.8471.51018.26
- Views 85
- Downloads 0
Efficacy of Airway Assessment Variables as Predictors of Difficult Intubation among Northeastern Population in India: A Hospital Based Prospective Study
Difficult intubation is an important cause of mortality in surgical patients; even more so when it is unanticipated. Predicting difficult intubation with the help of different airway parameters has been the endeavor of a...
Anaesthetic Management of a Case of Severe Pulmonary Artery Hypertension for Excission of A Vulval Mass
It is known that patients with pulmonary hypertension are at high risk for anaesthesia and surgery. Primary pulmonary hypertension (PPH) has now been replaced byidiopathic pulmonary hypertension or pulmonary artery hype...
Comparative Evaluation of the Incidence of Ventilator Associated Pneumonia in Intermittent Oral Suction Vs Continuous Subglottic Suction in Adult Neurosurgical Patient Requiring Mechanical Ventilation: A Randomized Control Trial
Introduction: Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection in intensive care units (ICUs). The impaired host defenses and continuous exposure of the lower respiratory tract to large numbe...
Comparative Study of Conventional Versus Nasal-18 Method for Fiberoptic Nasal Intubation
Background: Fiberoptic nasal intubation (FONI) is an effective technique for establishing airway access in patients with both anticipated and unanticipated difficult airways. Utilization of fiberscope without the use of...
Evaluation of Hyperbaric Intrathecal Ropivacaine and Levobupivacaine versus Racemic Bupivacaine in Patients with Infra-Umbilical Surgery: A Comparative Study
Introduction: Spinal anaesthesia is popular anaesthetic technique for lower abdominal and lower extremity surgery. Lidocaine and bupivacaine has been commonly used as anaesthetic agents. Ropivacaine had been found to be...