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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51018.26

Abstract

  Spinal anaesthesia is always a safe, cost effective and a better option in patients where general anaesthesia can be complicated and to fulfill the purpose of post­operative analgesia. After conducting many upper abdominal surgeries and open cholecystectomy under spinal anaesthesia, this study was conducted on single, three and conventional four port laparoscopic cholecystectomy under spinal anaesthesia to assess its efficacy, safety, reliability and as an alternative to general anaesthesia with minimum risk. This study was conducted on 300 patients of either sex belonging to ASA­I & II, age 20­70 years admitted for planned laparoscopic cholecystectomy. Bupivacaine (2.5 to 4ml) was injected indurally in lateral position at the level of L2. Dose of bupivacaine varied according to the feasibility and compatibility of the operating surgeon. Pneumoperitoneum with CO2 was created with the range of 10­14mmHg intra­abdominal pressure, according to the ease of the surgeon,at the rate of 1 L/min. Patients were sedated with Inj pentazocine 30mg and midazolam 2mg/diazepam 10mg intravenously after performing spinal anaesthesia. Any discomfort and intensity to the patient due to right shoulder pain was observed and managed accordingly from right shoulder massage to supplementation with propofol 1mg/kg. No patient was converted into general anaesthesia with tracheal intubation. Mean age was 41.7 years. Mean surgical duration was 53.19±12.55 min. Mean duration of sensory block was 157.39±23.47 min and mean duration of motor block was 134.17±19.52 min. Laparoscopic cholecystectomy can be performed under spinal anaesthesia with better outcome and safety without having any major complication.

Keywords : Spinal Anaesthesia; Single; Three & Four Port; Laparoscopic Cholecystectomy; Pneumoperitoneum; CO2Insufflation

Corresponding Author : Ajai Vikram Singh, Associate Professor, Department of Anaesthesia, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research (VCSGGMSRI), Srinagar, Garhwal, Srinagar, Uttarakhand 246174, India.