Laparoscopic cholecystectomy under spinal anesthesia: a pilot study.
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.
Tzovaras
G
G
Department of Surgery, University of Thessaly Medical School, University Hospital of Larissa, Greece. gtzovaras@hotmail.com
Fafoulakis
F
F
Pratsas
K
K
Georgopoulou
S
S
Stamatiou
G
G
Hatzitheofilou
C
C
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
D002245:Carbon Dioxide