European Journal of Biomedical and Pharmaceutical Sciences

SPINAL ANAESTHESIA FOR GENERAL LAPAROSCOPIC SURGERY

Dr. Prashant P. Jadhav*, Dr. Ranjeet Kamble, Dr. A. D. Kolekar and Dr. A. N. Supe

ABSTRACT

Objectives: Laparoscopic abdominal surgery is conventionally done under general anesthesia. Spinal anesthesia is usually preferred in patients where general anesthesia is contraindicated.The objective of our study was to use spinal anesthesia as the first choice for laparoscopic surgery cases at small scale hospitals with the intention that it is a good alternative to GA with no or insignificant side effects. Methodology: Spinal anesthesia was used in 223 elective laproscopic surgery patients. Intraabdominal pressure was kept at 12mm Hg to 14mm Hg. Sedation was given if required, and conversion to general anesthesia was done in long surgery patients, not responding to sedation or with failure of spinal anesthesia. Results were compared with those of 79 patients undergoing laparoscopic surgery while under general anesthesia. Results: Less than 10%(21) experienced neck or shoulder pain, or both. Intravenous Diclofenaec or Fortwin was required/given in all patients (99%), while Ketamine had to be given to 33 (12%) patients. 5 (less than 3%) patients required conversion because of extended duration of surgeries. We have not experienced failure of SA effect. Conclusion: The evidence suggests the safety of the use of spinal anaesthesia in general laparoscopy procedure with minimal side effects which can easily be managed with the available pharmacological drugs even at small scale hospitals. RA may provide certain advantages over GA, such includes lack of airway manipulation, maintenance of spontaneous respiration, effective post-operative analgesia, minimal nausea and vomiting, and early recovery and ambulation. RA may be considered comparable to GA in laparoscopic procedures regarding surgical conditions, intra- and post-operative complications, and hospital length of stay, but may be superior to GA with respect to the PONV, Post-Operative Analgesia, Early Recovery and Anesthesia Cost.

Keywords: Laparoscopic surgery, Spinal Anesthesia.