Journals / Haydarpaşa Numune Medical Journal / 2018 / Cilt: 58 - Sayı: 1

Laparoscopic Cholecystectomy Under Combined Spinal/ Epidural Anesthesia: A Retrospective Analysis of 112 Cases in Terms of Per- and Postoperative Outcomes

Pages
5–11
DOI
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Discussion and Conclusion: LC under CSEA with low-pressure CO2 pneumoperitoneum is feasible and safe.

📌 3 Key Takeaways

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Objective & Hypothesis:Introduction: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of benign gall bladder diseases.
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Key Findings & Data:The use of spinal (SA), epidural (EA), and combined spinal epidural anesthesia (CSEA) has increased in recent years.
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Conclusion & Impact:Discussion and Conclusion: LC under CSEA with low-pressure CO2 pneumoperitoneum is feasible and safe.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

Introduction: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of benign gall bladder diseases. The use of spinal (SA), epidural (EA), and combined spinal epidural anesthesia (CSEA) has increased in recent years. Methods: A total of 112 patients who underwent elective LC under CSEA for gall stones or polyps were retrospectively analyzed. Low-pressure CO2 pneumoperitoneum was used, and standard LC was performed. Patient demographics, ASA scores, comorbidities, surgery, anesthesia, and total time were recorded. Intraoperative complications (hypotension, bradycardia, hypoxemia, nausea/vomiting, right shoulder pain, anxiety or abdominal discomfort, and/or pain) were recorded. Postoperative shoulder pain, postdural puncture headache (PDPH), nausea/vomiting, urinary retention, anxiety, and abdominal discomfort and/or pain were also recorded. Results: LC was successful in all patients, except one. Seventy patients had VAS0=0, 40 (35.7%) had VAS0 <1, and two (1.8%) had VAS0 ≤2. The patient satisfaction score was 4 or 5 for 84.8% of patients. There was intraoperative abdominal discomfort, shoulder pain, and anxiety in 26 (23.2%), 13 (11.6%), and eight (7.1%) patients, respectively. Two patients (1.8%) developed intraoperative hypotension. Postoperatively, shoulder pain, urinary retention, nausea and vomiting, and PDPH were observed in 10 (8.9%), six (5.4%), four (3.6%), and four (3.6%) patients, respectively. Discussion and Conclusion: LC under CSEA with low-pressure CO2 pneumoperitoneum is feasible and safe.

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Cite This Article

SUNAMAK, O., DÖNMEZ, T., UZMAN, S., ERDEM, V. M., ERDEM, D. A., YILDIRIM, D., HUT, A., AVAROĞLU, H. İ., AKINCI, M. (2018). Laparoscopic Cholecystectomy Under Combined Spinal/ Epidural Anesthesia: A Retrospective Analysis of 112 Cases in Terms of Per- and Postoperative Outcomes. Haydarpaşa Numune Medical Journal, Cilt: 58 - Sayı: 1, 5–11. https://ajindex.com/articles/193333

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References (1)

  1. Reorganized text. JAMA Otolaryngol Head Neck Surg 2015;141:428. [CrossRef ] 2. Bencini L, Tommasi C, Manetti R, Farsi M. Modern approach to cholecysto-choledocholithiasis. World J Gastrointest Endosc 2014;6:32–40. [CrossRef ] 3. Joong Choi C, Roh YH, Kim MC, Choi HJ, Kim YH, Jung GJ. Single- Port Laparoscopic Cholecystectomy for Gall Bladder Polyps. JSLS 2015;19. pii: e2014.00183. 4. Fullum TM, Downing SR, Ortega G, Chang DC, Oyetunji TA, Van Kirk K, et al. Is laparoscopy a risk factor for bile duct injury during cholecystectomy? JSLS 2013;17:365–70. [CrossRef ] 5. Coccolini F, Catena F, Pisano M, Gheza F, Fagiuoli S, Di Saverio S, et al. Open versus laparoscopic cholecystectomy in acute cholecystitis. Systematic review and meta-analysis. Int J Surg 2015;18:196–204. [CrossRef ] 6. Yu G, Wen Q, Qiu L, Bo L, Yu J. Laparoscopic cholecystectomy under spinal anaesthesia vs. general anaesthesia: a meta- analysis of randomized controlled trials. BMC Anesthesiol 2015;15:176. [CrossRef ] 7. Hajong R, Khariong PD, Baruah AJ, Anand M, Khongwar D. Laparoscopic cholecystectomy under epidural anesthesia: a feasibility study. N Am J Med Sci 2014;6:566–9. [CrossRef ] 8. Singh RK, Saini AM, Goel N, Bisht D, Seth A. Major laparoscopic surgery under regional anesthesia: A prospective feasibility study. Med J Armed Forces India 2015;71:126–31. [CrossRef ] 9. Das W, Bhattacharya S, Ghosh S, Saha S, Mallik S, Pal S. Comparison between general anesthesia and spinal anesthesia in attenuation of stress response in laparoscopic cholecystectomy: A randomized prospective trial. Saudi J Anaesth 2015;9:184–8. [CrossRef ] 10. Rodgers A, Walker N, Schug S, McKee A, Kehlet H, van Zundert A, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ 2000;321:1493. [CrossRef ] 11. Tiwari S, Chauhan A, Chaterjee P, Alam MT. Laparoscopic cholecystectomy under spinal anaesthesia: A prospective, randomised study. J Minim Access Surg 2013;9:65–71. [CrossRef ] 12. Mehta N, Gupta S, Sharma A, Dar MR. Thoracic combined spinal epidural anesthesia for laparoscopic cholecystectomy in a geriatric patient with ischemic heart disease and renal insufficiency. Local Reg Anesth 2015;8:101–4. 13. Jadon A, Sinha N, Agarwal PS. Combined Spinal Epidural Anaesthesia with BiPAP-Three Case Reports. Indian J Anaesth 2009;53:478–81. 14. Sinha R, Gurwara AK, Gupta SC. Laparoscopic surgery using spinal anesthesia. JSLS 2008;12:133–8