General Anaesthesia versus Spinal Anaesthesia for Laparoscopic Cholecystectomy: Which Is Better Choice

Comparison between General Anaesthesia and Spinal

Abstract

Background: There is a growing evidence to suggest that regional anesthesia has an important role to play in the management of patients undergoing laparoscopic procedures. Subjects and Methods: We compared spinal anesthesia with general anesthesia, for laparoscopic cholecystectomy in 100 ASA grade 1 and 2 patients between the age of 18-50 years, divided equally into two groups given either GA or SA. The groups were compared by hemodynamic variables, intra operative events, post operative pain, operative conditions for surgeon and complications if any. Statistical Analysis: Data summarised as Mean SE.  Groups were compared by Students t test , (ANOVA), Newman-Keuls post hoc test and chi-square (?2) test. Results: Hemodynamic comparison showed better hemodynamic profile in group SA than group GA. The time of rescue analgesia was comparatively higher in SA than GA. The no. of diclofenac used lower comparatively in SA than GA. Comparing the intra operative events of two groups there was higher shoulder pain in SA as compared to GA. However, hypotension was found similar between the two groups. Post operative side effects  showed  higher pruritis  and urinary retention whereas lower sore throat  in SA as compared to GA. However PONV and headache were found similar between the two groups. There was higher surgeon and patient satisfaction in GA as compared to SA.   Conclusion: We concluded that laparoscopic cholecystectomy can be conducted safely under Spinal anaesthesia with excellent recovery and high degree of satisfaction in selected patients.