Comparing cholecystectomy in patients with chronic obstructive pulmonary disease under spinal anaesthesia and general anaesthesia

Abstract

Introduction: The prevalence of Chronic obstructive lung disease has been increased globally. We compared the effectiveness of SA versus GA for open cholecystectomy with regards to post operative pain reduction, analgesia requirement, respiratory complications and length of hospital stay in chronic obstructive lung disease patients. Materials and Methodology: Group 1 (the GA group) received 0.6 mg/kg rocuronium bromide, 2 mg/kg propofol, and 2 μg/kg fentanyl. After 90-120 seconds 100% oxygenation, these patients underwent endotracheal intubation. Maintenance of anaesthesia was performed using 1 – 2% sevoflurane in 50% nitrous oxide/50% oxygen. Group 2 (the SA group) received their anaesthesia while sitting. Patients underwent lumbar puncture using a 25 - gauge needle in the L3-L4 intervertebral space and were given an intrathecal injection of 25 mg fentanyl and 3ml hyperbaric bupivacaine (0.5%), following which they were told to lay supine for 5 minutes. Results: There was no significant difference between the GA and SA groups, postoperative pulmonary functions were impaired more frequently in the GA group, and 4 GA patients required mechanical ventilation. There was no significant difference in operation duration between the SA and GA groups. Conclusion: Cholecystectomy could be performed safely under GA and SA in patients with COPD.