Abstract
BackgroundEpidemiological data demonstrate that the worldwide prevalence of chronic obstructive pulmonary disease is increasing. These patients have an increased risk of mortality and morbidity and have constant limitations in airflow. Comparing laparoscopic cholecystectomy (LC) in patients with chronic obstructive pulmonary disease (COPD) under spinal anesthesia (SA) and general anesthesia (GA).MethodsWe prospectively evaluated COPD patients who underwent laparoscopic cholecystectomy under general anesthesia (Group 1, n = 30) or spinal anesthesia (Group 2, n = 30) in our clinic between January 2016 and January 2018. Patients with COPD were further divided into groups according to their preoperative stages (Stage 1–4). Intraoperative vital findings, postoperative pain, complications, and length of hospitalization were compared between the general (GA) and spinal anesthesia (SA) groups.ResultsThe mean age of the patients in the GA group was 61.0 ± 6.7 years and was 61.0 ± 7.7 years in the SA group. In the GA and SA groups, the mean ASA score was 2.8 ± 0.6 and 2.9 ± 0.6, respectively, the mean operation duration was 31.7 ± 5.1 and 30.6 ± 5.1 min, respectively, and the length of hospitalization was 3.2 ± 1.7 and 1.5 ± 0.5 days, respectively. The partial carbon dioxide rates (PaCO2) at the postoperative 5th and 20th minutes were lower in the SA group than in the GA group. Further, the requirement for postoperative analgesia was lower in the SA group, and the length of hospitalization was significantly shorter in the SA group. There was no significant difference between the two groups in terms of operation duration.ConclusionLaparoscopic cholecystectomy is a rather safe procedure for COPD patients under general and spinal anesthesia. However, spinal anesthesia is preferred over general anesthesia as it has better postoperative analgesia and causes no impairment of pulmonary functions.
Highlights
Epidemiological data demonstrate that the worldwide prevalence of chronic obstructive pulmonary disease is increasing
Laparoscopic cholecystectomy was performed under spinal anesthesia (30 patients) or general anesthesia (30 patients)
Bradycardia occurred in 1 patient (3.3%), and normocardia was maintained with 0.25 mg atropine
Summary
Epidemiological data demonstrate that the worldwide prevalence of chronic obstructive pulmonary disease is increasing These patients have an increased risk of mortality and morbidity and have constant limitations in airflow. Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of mortality and morbidity and have continuous limitations in airflow. These limitations are diagnosed by taking the ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC). For adults older than 40 years, COPD’s worldwide prevalence (as defined physiologically) is ~9–10% [2, 3] This high prevalence is putting a burden on both surgeons and anesthesiologists, who are both seeing an increase in the volume of high-risk respiratory patients.
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