Laparoscopic cholecystectomy under spinal versus general anesthesia: a prospective, randomized study.
BACKGROUND
For laparoscopic cholecystectomy (LC), the use of spinal anesthesia may offer several advantages over general anesthesia. The aim of this prospective, randomized study was to compare the surgical outcome of LC performed under general anesthesia to that of LC performed under spinal anesthesia.


METHODS
Sixty patients were randomly assigned to either the SALC (spinal anesthesia LC group, 30 patients) or GALC group (general anesthesia LC group, 30 patients). Intraoperative events related to spinal anesthesia, postoperative complications, and pain scores were recorded. Patient satisfaction as to the anesthetic technique received was assessed 2 weeks postoperatively by direct patient questionnaire.


RESULTS
In both groups, all procedures were completed laparoscopically. In the SALC group, all procedures were completed under spinal anesthesia and there were no anesthetic conversions. There was no statistically significant difference in the mean operative time between both groups. For the first 2 and 4 hours postoperatively, the mean pain score of the SALC group was statistically significantly lower than that of the GALC group. For the first 24 hours postoperatively, the mean number of analgesic ampoules/patient was statistically significantly lower in the SALC group. In the SALC group, 28 patients (93.3%) considered the technique "very well," compared with 30 patients (100%) in the GALC group. The difference in the overall patient satisfaction scores between both studied groups was not statistically significant.


CONCLUSIONS
LC performed under spinal anesthesia is feasible, safe, and is associated with significantly less early postoperative pain, compared to that performed under general anesthesia.
Bessa
Samer S
SS
Department of General Surgery, University of Alexandria, Alexandria, Egypt. samerbessa@gmail.com
El-Sayes
Islam A
IA
El-Saiedi
Mohamed K
MK
Abdel-Baki
Nabil A
NA
Abdel-Maksoud
Mervat M
MM
D000328:Adult; D000768:Anesthesia, General; D000775:Anesthesia, Spinal; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome