Comparison of PERI-Operative and Post-operative Events: Spinal Anesthesia versus General Anesthesia for Open Cholcystectomy

Abstract

Objective: To investigate perioperative and postoperative events as well as feasibility, effectiveness, safety of patient and surgeons satisfaction for open cholecystectomy under spinal anesthesia (SA) compared to General Anesthesia (GA). Material and Methods: All admitted and consented ASA I and ASA II patients of either sex with diagnosed cholelethiasis for elective open chlecystectomy were randomly divided into two groups. During open Cholecystectomy, the SA group received spinal anaesthesia (SA) using 3.00 ml to 3.5 ml of 0.5 percent hyperbaric Bupivacane intrathecally, while the GA group received propofol, Fentanyl Citrate, Atracurium, and Halothane. Other drugs are only used to treat anxiety, pain, nausea and vomiting, respiratory complications, and haemodynamic stability.  All open chlolecystectomy performed by right oblique incision. For two days, intraoperative and postoperative events were recorded. The primary areas of research were. Intraoperative complications (hypertension, bradycardia, nausea/vomiting, difficulty breathing, patient and surgeon satisfaction), post-operative painfree interval, PONV, and analgesia requirement Result: From July 2016 to December 2017, 200 patients with diagnosed cholelithiasis were admitted for open cholecystectomy, with 150 receiving adequate spinal anaesthesia and 50 preferring GA.  INTRA-OPERATIVELY, 18 patients in the SA group experienced respiratory difficulty, which was relieved by 100 percent O2 with a ventimask, 39 patients presented with hypotension, which was managed by injection Mephentermine, only 2 patients received injection Ephidrine, 12 patients experienced nausea and vomiting, which was treated with antiemetic (Injection Ondensetron), and 22 patients experienced pain, which was managed by injection tramadol. POST-OPERATIVELY: Both groups of patients were observed for pain free interval and PONV. Conclusion: Patients undergoing uncomplicated open cholecystectomy under spinal anaesthesia are safer and more effective than G.A. in terms of intraoperative events, post-operative analgesia, PONV, cost effectiveness, and surgeon and patient satisfaction.