title: Comparison of Postoperative Events between Spinal Anesthesia and General Anesthesia in Laparoscopic Cholecystectomy: A Systemic Review and Meta-Analysis of Randomized Controlled Trials.
abstract: Background. Laparoscopic cholecystectomy is usually carried out under general anesthesia. There were a few studies which have found spinal anesthesia as a safe alternative. We aimed to evaluate the postoperative events between spinal anesthesia and general anesthesia in patients undergoing laparoscopic cholecystectomy. Methods. We searched PubMed, Embase, and Cochrane Library (from inception to January 2016) for eligible studies. The primary outcome was the visual analogue scale score. Secondary outcomes included postoperative nausea and vomiting and urine retention 24 hours postoperatively. We calculated pooled risk ratios and 95% confidence interval using random- or fixed-effects models. Results. Eight trials involving 723 patients were listed. Meta-analysis showed that patients in spinal anesthesia groups have lower visual analogue scale score 24 hours postoperatively. There were significant decreases in the occurrence of postoperative nausea and vomiting in spinal anesthesia group when compared with general anesthesia group (odds ratios: 0.38, 95% confidence interval: 0.19-0.76; P = 0.006) with heterogeneity accepted (I (2) = 13%; P = 0.33), while urine retention rate was increased in patients with spinal anesthesia (odds ratios: 4.95, 95% confidence interval: 1.24-19.71; P = 0.02) without any heterogeneity (I (2) = 0%; P = 0.98). Conclusions. Spinal anesthesia may be associated with less postoperative pain and postoperative nausea and vomiting compared with general anesthesia.
authors.affiliation: Department of Anesthesiology, The First People's Hospital of Changde City, Changde, Hunan 415003, China.
authors.forename: Xian-Xue
authors.initials: XX
authors.lastname: Wang
authors.affiliation: Science & Education Division, The First People's Hospital of Changde City, Changde, Hunan 415003, China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Anesthesiology, The First People's Hospital of Changde City, Changde, Hunan 415003, China.
authors.forename: Dao-Bo
authors.identifier: 0000-0003-1969-7349
authors.initials: DB
authors.lastname: Pan
authors.affiliation: Department of Anesthesiology, The First People's Hospital of Changde City, Changde, Hunan 415003, China.
authors.forename: Hui-Wei
authors.initials: HW
authors.lastname: Deng
authors.affiliation: Department of Anesthesiology, The First People's Hospital of Changde City, Changde, Hunan 415003, China.
authors.forename: Ai-Guo
authors.initials: AG
authors.lastname: Zhou
authors.affiliation: Department of Anesthesiology, The First People's Hospital of Changde City, Changde, Hunan 415003, China.
authors.forename: Hua-Jing
authors.initials: HJ
authors.lastname: Guo
authors.affiliation: Department of Anesthesiology, The First People's Hospital of Changde City, Changde, Hunan 415003, China.
authors.forename: Fu-Rong
authors.initials: FR
authors.lastname: Huang
mesh_terms: D000328:Adult; D017677:Age Distribution; D000768:Anesthesia, General / Q000706:statistics & numerical data*; D000775:Anesthesia, Spinal / Q000706:statistics & numerical data*; D015984:Causality; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D005705:Gallbladder Diseases / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000453:epidemiology* / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology* / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome; D016055:Urinary Retention / Q000453:epidemiology* / Q000517:prevention & control