Abstract :
Background and Aims: General anesthesia (GA), which has been a gold standard for laparoscopic cholecystectomy (LC), has limitations in certain patients. This randomised controlled trial compared the hemodynamic changes between GA and an alternative anesthetic technique, thoracic segmental spinal anesthesia (TSSA) for LC.
Materials and Methods: Hundred adult patient scheduled for elective LC were randomised into group T(TSSA) and Group G (GA) of 50 patients each. Group G patients received conventional GA with intubation and mechanical ventilation while group T patients received TSSA (1.5 ml of 0.75% ropivacaine with dexmedetomidine 6mcg as an adjuvant was injected intrathecally in one of the interspinous space between T7- T12). Primary objective of our study was to compare the intra operative hemodynamic changes. Secondary objective was to compare the intraoperative and post operative adverse effects. Statistical Package for Social Sciences (SPSS) software version 22 was used for statistical analysis after entering the data into Microsoft Excel spreadsheet.
Results: All 100 patients were analysed for study. Group T showed greater hemodynamic stability after an initial dip (at 5 min) in heart rate, systolic and diastolic blood pressure. Group G showed greater rise in intra-operative hemodynamic parameters at all time points after insufflation. There was no neurological complication in group T. Incidence of post operative pain abdomen in the first six hours and sore throat was more in group G.
Conclusion: TSSA provides greater hemodynamic stability with minimal side-effects as compared to GA and offers an effective and acceptable alternative for LC.
Keyword :
Segmental, Regional, Spinal, General, Anesthesia, Hemodynamics.