title: Laparoscopic Cholecystectomy Under Spinal Anaesthesia vs. General Anaesthesia: A Prospective Randomised Study.
abstract: BACKGROUND
  Laparoscopic cholecystectomy (LC) is conventionally performed under general anaesthesia (GA) in our institution. There are multiple studies which have found spinal anaesthesia as a safe alternative. We have conducted this study of LC, performed under spinal anesthesia to assess its safety and feasibility in comparison with GA.
  
  
  METHODS
  Fifty patients with symptomatic gallstone disease and American Society of Anesthesiologists status I or II were randomised to have LC under spinal (n = 25) or general (n = 25) anesthesia. Intraoperative vitals, postoperative pain, complications, recovery, and surgeon satisfaction were compared between the 2 groups.
  
  
  RESULTS
  In the SA group six patients (24%) complained of shoulder pain, two patients required conversion to GA (8%) as the pain did not subside with Fentanyl. None of the patients in the SA group had immediate postoperative pain at operated site. Only two (8%) patients had pain score of 4 at the operative site within eight hours requiring rescue analgesic. One patient had nausea but no vomiting (4%). All the patients (100%) in the GA group had pain at operated site immediately after surgery and their pain score ranged from 4-7, all patients received rescue analgesic before shifting to the ward. In the first 24h tramadol required as rescue in the GA group was 82±24 mg which was significantly higher than the SA group requiring only 30±33.16 mg. Although, the GA group had more patients experiencing postoperative nausea & vomiting it was not statistically significant.
  
  
  CONCLUSIONS
  SA as the sole anaesthesia technique is feasible, safe and cost effective for elective LC.
authors.affiliation: Associate Professor, Department of Surgery, M S Ramaiah Medical College & Hospitals , New BEL Road, MSR Nagar, Bangalore, India .
authors.forename: Kalaivani
authors.initials: K
authors.lastname: V
authors.affiliation: Associate Professor, Department of Anaesthesiology, M S Ramaiah Medical College & Hospitals , New BEL Road, MSR Nagar, Bangalore, India .
authors.forename: Vinayak S
authors.initials: VS
authors.lastname: Pujari
authors.affiliation: Professor, Department of Surgery, M S Ramaiah Medical College & Hospitals , New BEL Road, MSR Nagar, Bangalore, India .
authors.forename: Sreevathsa M
authors.initials: SM
authors.lastname: R
authors.affiliation: Professor, Department of Surgery, M S Ramaiah Medical College & Hospitals , New BEL Road, MSR Nagar, Bangalore, India .
authors.forename: Bharati V
authors.initials: BV
authors.lastname: Hiremath
authors.affiliation: Associate Professor, Department of Anaesthesiology, M S Ramaiah Medical College & Hospitals , New BEL Road, MSR Nagar, Bangalore, India .
authors.forename: Yatish
authors.initials: Y
authors.lastname: Bevinaguddaiah
keywords: Cholecystectomy; Gallstone disease; Laparoscopic cholecys-tectomy; Laparoscopy; Regional anesthesia; Spinal anesthesia