Efficacy of Segmental Thoracic Spinal Anaesthesia in Laparoscopic Cholecystectomy

Abstract

Introduction: Segmental Thoracic Spinal Anesthesia (STSA) in Laparoscopic Cholecystectomy represents a significant advancement in the field of anesthesiology, offering a viable alternative to the traditional general anesthesia (GA) for this procedure. Aim of the study: The aim of this study was to assess the efficacy of segmental thoracic spinal anaesthesia in laparoscopic cholecystectomy. Methods: This prospective observational study, conducted at the Department of Anaesthesia, Analgesia and Intensive care medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from June to December 2023, included 60 patients undergoing laparoscopic cholecystectomy. They were divided into two groups of 30 each: Group A received segmental thoracic spinal anesthesia, and Group B underwent surgery under general anesthesia. Result: Group A and Group B were demographically similar, with no significant differences in age, sex, BMI, ASA grading, or cholecystectomy indications. Group A had a shorter anesthesia duration (83.0 ± 25.1 min) compared to Group B with 97.8 ± 29.5 min (p=0.0407). Surgical time and intraoperative fluid volume showed no significant difference. Group A experienced more bradycardia (13.3%) and shoulder pain (16.7%), while Group B had more nausea (13.3%) and hypotension (10%). Postoperatively, Group A had a shorter hospital stay and quicker recovery. Group A reported less shoulder pain (6.7% vs. 26.7%, p=0.0395) and no nausea. VAS scores were consistently lower in Group A at all postoperative times, indicating better pain management. Conclusion: The study conclusively demonstrates that thoracic segmental spinal anesthesia offers comparable significant advantages in laparoscopic cholecystectomy with shorter durations of anesthesia, quicker postoperative recovery, and reduced postoperative pain.