title: Laparoscopic cholecystectomy under spinal anaesthesia: A prospective, randomised study.
abstract: BACKGROUND
  Spinal anaesthesia has been reported as an alternative to general anaesthesia for performing laparoscopic cholecystectomy (LC).
  
  
  OBJECTIVE
  Study aimed to evaluate efficacy, safety and cost benefit of conducting laparoscopic cholecystectomy under spinal anaesthesia (SA) in comparison to general anaesthesia(GA).
  
  
  METHODS
  A prospective, randomised study conducted over a two year period at an urban, non teaching hospital.
  
  
  METHODS
  Patients meeting inclusion criteria e randomised into two groups. Group A and Group B received general and spinal anaesthesia by standardised techniques. Both groups underwent standard four port laparoscopic cholecystectomy. Mean anaesthesia time, pneumoperitoneum time and surgery time defined primary outcome measures. Intraoperative events and post operative pain score were secondary outcome measure.
  
  
  METHODS
  The Student t test, Pearson's chi-square test and Fisher exact test.
  
  
  RESULTS
  Out of 235 cases enrolled in the study, 114 cases in Group A and 110 in Group B analysed. Mean anaesthesia time appeared to be more in the GA group (49.45 vs. 40.64, P = 0.02) while pneumoperitoneum time and corresponding the total surgery time was slightly longer in the SA group. 27/117 cases who received SA experienced intraoperative events, four significant enough to convert to GA. No postoperative complications noted in either group. Pain relief significantly more in SA group in immediate post operative period (06 and 12 hours) but same as GA group at time of discharge (24 hours). No late postoperative complication or readmission noted in either group.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy done under spinal anaesthesia as a routine anaesthesia of choice is feasible and safe. Spinal anaesthesia can be recommended to be the anaesthesia technique of choice for conducting laparoscopic cholecystectomy in hospital setups in developing countries where cost factor is a major factor.
authors.affiliation: Department of Surgery, Military Hospital, Agra, Uttar Pradesh, India.
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Tiwari
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Chauhan
authors.forename: Pallab
authors.initials: P
authors.lastname: Chaterjee
authors.forename: Mohammed T
authors.initials: MT
authors.lastname: Alam
keywords: General anaesthesia; laparoscopic cholecystectomy; spinal anaesthesia