A comparative study between Spinal vs General Anesthesia for Laparoscopic appendectomy A randomized controlled trial

Sushil Kumar; Veena. Horo

Volume : VIII, Issue : II, February - 2019

A comparative study between Spinal vs General Anesthesia for Laparoscopic appendectomy A randomized controlled trial

Sushil Kumar, Veena. Horo

Abstract :

Appendectomy is one of the most commonly performed surgery in modern day surgical practice. While laparoscopic appendectomy has been well established as a widespread and standard method for appendectomy surgery, there is ambiguity about the best method of anesthesia for laparoscopic appendectomy surgery. While General anesthesia is the preferred and accepted method for laparoscopic appendectomy surgery , spinal anesthesia with supplemental sedation is being very widely tried and found to be at least as satisfactory if not better than General Anesthesia Plus the added advantages of cost effectiveness and better postoperative analgesia makes spinal anesthesia a very acceptable alternative to GA for lap appendectomy. We designed a staudy to compare spinal vs. General anesthesia in a controlled study and found spinal anesthesia to be better than GA for lap appendectomy. Objectives of study : To compare spinal anesthesia with the currently accepted gold standard technique i.e. general anesthesia for elective laparoscopic appendectomy. Setting: Medical College Hospital Design: Controlled randomized trial. Settings and Study design: One hundred patients with symptomatic gallstone disease and American Society of Anesthesiologists status I or II were randomized to have laparoscopic appendectomy under spinal (n=50) or general (n=50) anesthesia. Materials and Methods: Patients meeting inclusion criteria were randomised into two groups. Group A and Group B received general and spinal anaesthesia by standardised techniques. Both groups underwent standard four port laparoscopic appendectomy. Mean anaesthesia time and surgery time defined primary outcome measures. Intraoperative events and post operative pain score were secondary outcome measure. Intraoperative parameters, postoperative pain, complications, recovery, and patient satisfaction at follow up were compared between the 2 groups. Statistical Analysis Used : Student t test and chi square test Results : All the procedures were completed by the allocated method of anesthesia, as there were no conversions from spinal to general anesthesia. Pain was significantly less at 4 hours (P_.001), 8 hours (P_.001), 12 hours (P_.001), and 24 hours (P=.02) after the procedure for the spinal anesthesia group compared with those who received general anesthesia. There was no difference between the 2 groups regarding complications, hospital stay, recovery, or degree of satisfaction at follow-up. Conclusions : Spinal anesthesia is adequate and safe for laparoscopic appendectomy in otherwise healthy patients and offers better postoperative pain control than general anesthesia with similar recovery times and better patient satisfaction to some extent. Also, all the complications associated with general anesthesia can be avoided and conduct of anesthesia becomes safer.