General Anesthesia versus Spinal Anesthesia for Laparoscopic Cholecystectomy
| Autor: | Luiz Eduardo Imbelloni, José Antônio Cordeiro, José Carlos Fialho, Raphael Sant’Anna, Marcos Fornasari |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Anesthesia General Anesthesia Spinal CIRURGIA Abdominal: colecistectomia laparoscópica Sevoflurane Fentanyl Young Adult SURGERY Abdominal: laparoscopic cholecystectomy Patient satisfaction Pneumoperitoneum medicine Humans ANESTESIA Geral Rocuronium Retrospective Studies subaracnoidea business.industry Tracheal intubation Middle Aged medicine.disease Surgery Anesthesiology and Pain Medicine ANESTHETIC TECHNIQUE Regional: subarachnoid Cholecystectomy Laparoscopic Anesthesia Cholecystectomy Female TÉCNICA ANESTÉSICA Regional Propofol business medicine.drug |
| Zdroj: | Brazilian Journal of Anesthesiology. 60(3):217-227 |
| ISSN: | 0034-7094 |
| DOI: | 10.1016/s0034-7094(10)70030-1 |
| Popis: | Summary Background and objectives Laparoscopic cholecystectomy is the treatment of choice for cholelithiasis. The objective of this study was to compare the possibility of performing laparoscopic cholecystectomy under spinal anesthesia versus general anesthesia. Methods Between July 2007 and September 2008, 68 patients with symptoms of cholelithiasis were included in this study. Patients with physical status ASA I and II were randomly divided to undergo laparoscopic cholecystectomy with low-tension pneumoperitoneum with CO 2 under general anesthesia (n = 33) or spinal anesthesia (n = 35). Propofol, fentanyl, rocuronium, sevoflurane, and tracheal intubation were used for general anesthesia. Hyperbaric bupivacaine 15 mg, and fentanyl 20 μg to achieve a sensorial level of T 3 were used for the spinal anesthesia. Intraoperative parameters, postoperative pain, complications, recovery, patient satisfaction, and cost were compared between both groups. Results All surgical procedures were completed with the chosen method and spinal anesthesia was converted to general anesthesia only in one patient. Pain was significantly lower at 2, 4, and 6 hours after the procedure under spinal anesthesia. The cost of the spinal anesthesia was significantly lower than that of the general anesthesia. All patients were discharged after 24 hours. In the postoperative evaluation, all patients were satisfied with the spinal anesthesia and would recommend this procedure. Conclusions Laparoscopic cholecystectomy with low-pressure pneumoperitoneum with CO 2 can be safely performed under spinal anesthesia. Spinal anesthesia was associated with an extremely low level of postoperative pain, better recovery, and lower cost than general anesthesia. |
| Databáze: | OpenAIRE |
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