INTRODUCTION – Laparoscopic abdominal surgery is conventionally done under general anesthesia Spinal anesthesia is usually preferred in patients where general anesthesia is contraindicated. We present our experience of using spinal anesthesia as the first choice for laparoscopic surgery over a period of over 10 years with the contention that it is a better alterative to anesthesia.
METHODS & PROCEDURE –Spinal anesthesia was used in 4645 patients ,over the last 11 years .2992 underwent laparoscopic cholecystectomy and the rest, other laparoscopic surgeries. There was no modification in technique and the intraabdominal pressure was kept at 8-10 mm of Hg. Sedation was given if required and conversion to general anesthesia was done in patients not responding to sedation or with failure of spinal anesthesia. Results were compared with those of 421 patients undergoing lap surgery under GA
RESULTS- 24(0.01%) patients required conversion to general anesthesia . Hypotension requiring support was recorded in 846(18.21%) patients and 571(12.29%) patients experienced neck and or shoulder pain.. Postoperatively 2.09%(97) patients had vomiting as compared to 29.22% (123 patients) in patients administered general aesthesia . 35.59% (1672) patients required injectable diclofenac for their abdominal pain within 2 hours postoperatively and oral analgesic was required in 2936 (63.21%)patients within the first 24 hours. While 90.02% patients operated under GA required injectable analgesics in the immediate post operative period. Postural headache persisting for average 2.6 days was seen in 255(5.4%) patients postoperatively. Average time to discharge was 2.3 days. Kernofsky’s performance status showed a 98.6% satisfaction level in patients.
CONCLUSIONS- Laparoscopic surgery done under spinal anesthesia has a number of advantages over general anesthesia.
Session: Podium Presentation
Program Number: S110