title: Laparoscopic cholecystectomy under spinal anesthesia: a pilot study.
abstract: BACKGROUND
  Regional anesthesia has not been used as the sole anesthetic procedure other than in the scenario of a patient at high risk to undergo laparoscopic cholecystectomy with CO2 pneumoperitoneum under general anesthesia.
  
  
  METHODS
  Fifteen ASA grade I or II patients underwent laparoscopic cholecystectomy with low-pressure CO2 pneumoperitoneum under spinal anesthesia. Intraoperative parameters, postoperative pain and recovery in general, as well as patient satisfaction at follow-up were prospectively recorded in a pilot study to assess the feasibility and safety of the procedure.
  
  
  RESULTS
  All operations were completed laparoscopically and conversion from spinal to general anesthesia was not required in any of the cases. Median pain score 4 h postoperatively was 1.5 (range, 0-5), at 8 h it was 1 (range, 0-6), and at 24 h it was 1 (range, 0-4). All patients were discharged after 24 h. Follow-up 2 weeks postoperatively showed all but one patient to be satisfied and strongly recommending the anesthetic procedure.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy with low-pressure CO2 pneumoperitoneum can be successfully and safely performed under spinal anesthesia. Furthermore, it seems that spinal anesthesia is associated with minimal postoperative pain and at least an equally good recovery as with general anesthesia.
authors.affiliation: Department of Surgery, University of Thessaly Medical School, University Hospital of Larissa, Greece. gtzovaras@hotmail.com
authors.forename: G
authors.initials: G
authors.lastname: Tzovaras
authors.forename: F
authors.initials: F
authors.lastname: Fafoulakis
authors.forename: K
authors.initials: K
authors.lastname: Pratsas
authors.forename: S
authors.initials: S
authors.lastname: Georgopoulou
authors.forename: G
authors.initials: G
authors.lastname: Stamatiou
authors.forename: C
authors.initials: C
authors.lastname: Hatzitheofilou
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal; D002245:Carbon Dioxide; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D002769:Cholelithiasis / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D010865:Pilot Projects; D011028:Pneumoperitoneum, Artificial; D011446:Prospective Studies; D020069:Shoulder Pain / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide