Efficacy and safety of segmental spinal anaesthesia in laparoscopic cholecystectomy: A prospective study

Abstract

Laparoscopic cholecystectomy is usually conducted under general anaesthesia(GA) which has its own limitations and may be associated with certain complications. This single-arm prospective interventional study was done to assess the safety and efficacy of thoracic segmental spinal anaesthesia(TSSA) as a sole anaesthetic procedure in patients undergoing laparoscopic cholecystectomy. TSSA was administered to 50 patients of the American Society of Anaesthesiologists physical status 1, 2, 3, who were scheduled for elective laparoscopic cholecystectomy (1.5 ml of 0.75% ropivacaine with dexmedetomidine 6 µg as an adjuvant was injected in one of the intervertebral spaces between T7- T12). The primary objective of the study was to evaluate the efficacy and safety of TSSA to provide complete surgical anaesthesia in terms of the total number of cases converted to GA. The data was analysed using SciPy(version 1.3.1), a statistical analysis package, in Python programming language (version 3.7.4). Our study revealed that TSSA provided complete surgical anaesthesia in 48 patients and in two patients there was a failure to achieve adequate sensory block and GA had to be administered. The median time for full sensory regression was 90 min and the median time for complete motor regression was 60 min. No major intraop or postop adverse event was noted.TSSA offers safe and satisfying operating conditions for elective laparoscopic cholecystectomy. This technique practised with caution can provide a useful alternative to GA, especially in conditions where GA may have limitations.