scholarly journals Spinal Versus General Anesthesia for Laparoscopic Cholecystectomy

2018 ◽  
Vol 25 ◽  
pp. 55-58
Author(s):  
SMA Taher ◽  
Jamil Raihan ◽  
M Abu Zahid ◽  
AK Azad ◽  
MI Alam ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Regional Anesthesia ◽  
Gold Standard ◽  
Randomised Trial ◽  
Gall Stone ◽  
Chronic Obstructive ◽  
First Time ◽  
Symptomatic Gall Stone

Laparascopic Cholecystectomy under regional anesthesia alone has been reported only with severe chronic obstructive airway disease1,2. In a randomised trial, epidural with general anesthesia have been found to be more effective in lessening postoperative pain compare with general anesthesia alone3. Regional anesthesia has been successfully used for laparascopic cholecystectomy in patient. Hamad and Ibrahim El-Khatter4 used spinal anesthesia for laparoscopic for the first time. We performing Laparascopic Cholecystectomy with carbondioxide pneumoperitoneum under spinal anesthesia alone of healthy patients with symptomatic gall stone disease5. We design a control randomized trial to compare spinal anesthesthesia with the Gold standard general anesthesia for elective Laparascopic Cholecystectomy in healty patients.TAJ 2012; 25: 55-58

scholarly journals Prospective randomised trial of standard pressure versus low pressure laparoscopic cholecystectomy in a tertiary care hospital from Kolkata: Our experience

2018 ◽  
Vol 9 (4) ◽  
pp. 17-22
Author(s):  
Bikash Chandra Ghosh ◽  
Ambar Gangopadhyay
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Gall Stone ◽  
Low Pressure ◽  
Stone Disease ◽  
Care Hospital ◽  
Significant Difference ◽  
Gall Stone Disease ◽  
Standard Pressure ◽  
Symptomatic Gall Stone

Background: Laparoscopic cholecystectomy (LC), the procedure of choice for symptomatic gall stone disease. An emerging trend is to perform Low pressure pnuemoperitonium laparoscopic surgery as it has additive advantages over standard pressure to avoid complications while providing adequate working space.Aims and Objectives: The current study was designed with an aim to compare the advantage of low pressure pneumoperitoneum vs standard pressure pneumoperitoneum in laparoscopic cholecystectomy.Materials and Methods: The study was conducted in the department of General Surgery in R.G.Kar Medical College from January 2014 to June 2015. A total of 52 patients with symptomatic gall stone disease were recruited, 26 patients in each group randomly. Some intraoperative and post-operative parameters were studied.Results: All the intra-operative (IO) cardio-respiratory parameters (Pulse, Mean Arterial Pressure (MAP), End tidal CO2, spO2) were recorded just before incision, 20 minutes intra-operatively and before reversal of general anesthesia (GA). The IO parameters in our study, were found to be significant only at 20 minutes IO and before reversal of GA. The post-operative (PO) parameters (Pulse, MAP, Respiratory rate, spO2) and pain by VAS score at 6 hours, 12 hours and 24 hours post-operatively were studied. In PO period, we observed significant differences at 2 hours post-operatively in all parameters except MAP. There was significant difference in pain at 6, 12 and 24 hours when compared in both groups. The shoulder tip pain (STP) and 2 hours PO nausea and vomiting were found to be significantly higher in Standard pressure Laparoscopic cholecystectomy (SPLC) compared to Low pressure Laparoscopic cholecystectomy (LPLC). The operative time, duration of hospital stay and return to normal life after surgery though had differences but it was statisticallyinsignificant.Conclusion: Low pressure laparoscopic surgery is safe with least post operative complications when performed by experienced surgeons even in patients of ASA III.Asian Journal of Medical Sciences Vol.9(4) 2018 17-22

scholarly journals Comparison of Postoperative Events between Spinal Anesthesia and General Anesthesia in Laparoscopic Cholecystectomy: A Systemic Review and Meta-Analysis of Randomized Controlled Trials

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Xian-Xue Wang ◽  
Quan Zhou ◽  
Dao-Bo Pan ◽  
Hui-Wei Deng ◽  
Ai-Guo Zhou ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Confidence Interval ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Meta Analysis ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Urine Retention ◽  
Anesthesia Group

Background. Laparoscopic cholecystectomy is usually carried out under general anesthesia. There were a few studies which have found spinal anesthesia as a safe alternative. We aimed to evaluate the postoperative events between spinal anesthesia and general anesthesia in patients undergoing laparoscopic cholecystectomy.Methods. We searched PubMed, Embase, and Cochrane Library (from inception to January 2016) for eligible studies. The primary outcome was the visual analogue scale score. Secondary outcomes included postoperative nausea and vomiting and urine retention 24 hours postoperatively. We calculated pooled risk ratios and 95% confidence interval using random- or fixed-effects models.Results. Eight trials involving 723 patients were listed. Meta-analysis showed that patients in spinal anesthesia groups have lower visual analogue scale score 24 hours postoperatively. There were significant decreases in the occurrence of postoperative nausea and vomiting in spinal anesthesia group when compared with general anesthesia group (odds ratios: 0.38, 95% confidence interval: 0.19–0.76;P=0.006) with heterogeneity accepted (I2=13%;P=0.33), while urine retention rate was increased in patients with spinal anesthesia (odds ratios: 4.95, 95% confidence interval: 1.24–19.71;P=0.02) without any heterogeneity (I2=0%;P=0.98).Conclusions. Spinal anesthesia may be associated with less postoperative pain and postoperative nausea and vomiting compared with general anesthesia.

scholarly journals Regional or general anesthesia for fast-track hip and knee replacement - what is the evidence?

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 1449 ◽  
Author(s):  
Henrik Kehlet ◽  
Eske Kvanner Aasvang
Keyword(s):  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Regional Anesthesia ◽  
Hip Arthroplasty ◽  
Afferent Input ◽  
Bladder Function ◽  
Anesthetic Techniques ◽  
Thromboembolic Complications ◽  
General Anesthetic ◽  
Knee And Hip Arthroplasty

Regional anesthesia for knee and hip arthroplasty may have favorable outcome effects compared with general anesthesia by effectively blocking afferent input, providing initial postoperative analgesia, reducing endocrine metabolic responses, and providing sympathetic blockade with reduced bleeding and less risk of thromboembolic complications but with undesirable effects on lower limb motor and urinary bladder function. Old randomized studies supported the use of regional anesthesia with fewer postoperative pulmonary and thromboembolic complications, and this has been supported by recent large non-randomized epidemiological database cohort studies. In contrast, the data from newer randomized trials are conflicting, and recent studies using modern general anesthetic techniques may potentially support the use of general versus spinal anesthesia. In summary, the lack of properly designed large randomized controlled trials comparing modern general anesthesia and spinal anesthesia for knee and hip arthroplasty prevents final recommendations and calls for prospective detailed studies in this clinically important field.

scholarly journals Anesthesia and Respiratory Disorders

2019 ◽  
Author(s):  
Pranav Bansal ◽  
Mayuri Gupta ◽  
Ishrat Yousuf
Keyword(s):  
Carbon Dioxide ◽  
Chronic Obstructive Pulmonary Disease ◽  
Laparoscopic Cholecystectomy ◽  
Oxygen Saturation ◽  
General Anesthesia ◽  
Endotracheal Tube ◽  
Chronic Obstructive ◽  
Oral Antibiotics ◽  
Obstructive Pulmonary Disease ◽  
The Past

A 56- year old male patient, chronic smoker for the past 30 years, is known case of chronic obstructive pulmonary disease. pre-operative stabilization with inhaled bronchodilators, oral antibiotics and mucolytics the patient is posted for laparoscopic cholecystectomy. After induction of general anesthesia and securing airway with endotracheal tube, the surgery is started. After insufflation of abdomen with carbon-dioxide, the oxygen saturation falls and ventilation becomes difficult as judged by difficulty in pressing reservoir bag in Bain’s circuit.

scholarly journals CYSTIC ARTERY VARIATIONS IN LAPAROSCOPIC CHOLECYSTECTOMY

1969 ◽  
Vol 6 (1) ◽  
pp. 714-717
Author(s):  
MUHAMMAD HUSSAIN ◽  
ADNAN BADAR ◽  
MANZOOR ALI ◽  
SHAHID ALAM ◽  
NAIK ZADA ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anesthesia ◽  
Hepatic Artery ◽  
Cystic Duct ◽  
Gold Standard ◽  
Cystic Artery ◽  
Common Hepatic Artery ◽  
Hepatic Parenchyma ◽  
Right Hepatic Artery ◽  
Calot’S Triangle

BACKGROUND: Lap cholecystectomy is gold standard for cholelithiasis. Earlier the incidence ofmorbidity and mortality was higher. Later on with the understanding of anatomy and fine techniquesboth morbidity and mortality decreased. Understanding of the anatomy of calot’s triangle reduces thecomplications of the procedure.OBJECTIVE: To study the pattern of variations in cystic artery and comparison with Caucasians.MATERIAL AND METHODS: All laparoscopic cholecystectomies performed in Shah MedicalCentre,over a period of 1 year from January 2013 to December 2013,in whom detailed anatomy ofcalot’s triangle was clearly displayed were included in the study. Those laparoscopic cholecystectomiesin whom the detailed anatomy was not clear were excluded from the study.Laparoscopic cholecystectomies were performed under general anesthesia. The anatomy of cystic arteryand its branches were identified, and it was also correlated in relation to cystic duct and common hepaticduct.We performed 240 lap cholecystectomies over a period of 1 year from January 2013 to December 2013.RESULTS: The pattern of cystic artery was studied in 240 laparoscopic procedures. Origin of cysticartery from right hepatic artery was observed in 82% cases. Double cystic arteries were observed in 8%cases. Common hepatic artery gave rise to 6% cystic arteries. Cystic arteries originated fromgastroduodenal artery in 3% cases. Hepatic parenchyma gave rise to 2% cases.CONCLUSION: Percentage of variations in cystic artery as compared to Caucasians are not different inour study.These variations should be kept in mind to reduce complications.KEYWORDS: laparoscopic cholecystectomy, calot’s triangle, hepatic artery, cystic artery.

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