Technical Notes and Tips: Spinal Anaesthesia for Laparoscopic Cholecystectomy: In Practice, Safe, and Feasible

Abstract

While visiting a charitable hospital in Northern India, I found spinal anaesthesia a common practice for laparoscopic cholecystectomies. Most anaesthetists had experience of over 500 cases using spinal anaesthesia and preferred the L2–L3 level. There was a consensus on using glycopyrrolate and an anti-emetic for premedication and preloading the patient with 10–20 ml/kg of intravenous fluid. Often, anaesthesia was complimented with ketamine. All recommend a 10° Trendelenburg position with a support under the head up to the angle of scapula. With close monitoring, the technique is highly successful with only a rare abandoning of procedure due to shoulder tip pain.