Laparoscopic cholecystectomy under epidural anesthesia: a clinical feasibility study.
BACKGROUND
Laparoscopic cholecystectomy (LC) has traditionally been performed under general anesthesia, however, owing in part to the advancement of surgical and anesthetic techniques, many laparoscopic cholecystectomies have been successfully performed under the spinal anesthetic technique. We hoped to determine the feasibility of segmental epidural anesthesia for LC.


METHODS
Twelve American Society of Anesthesiologists class I or II patients received an epidural block for LC. The level of epidural block and the satisfaction score of patients and the surgeon were checked to evaluate the efficacy of epidural block for LC.


RESULTS
LC was performed successfully under epidural block, with the exception of 1 patient who required a conversion to general anesthesia owing to severe referred pain. There were no special postoperative complications, with the exception of one case of urinary retention.


CONCLUSIONS
Epidural anesthesia might be applicable for LC. However, the incidence of intraoperative referred shoulder pain is high, and so careful patient recruitment and management of shoulder pain should be considered.
Department of Aneshesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
Ji Hyun
JH
Lee
Jin
J
Huh
Duk Kyung
DK
Kim
Jea Ryoung
JR
Gil
Sung Won
SW
Min
Sun Sook
SS
Han
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