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Der Anaesthesist

, Volume 60, Issue 8, pp 723–728 | Cite as

RETRACTED ARTICLE: Different anesthesia methods for laparoscopic cholecystectomy

  • X. LiuEmail author
  • C. Wei
  • Z. Wang
  • H. Wang
Originalien

Abstract

Objectives

The aim of the study was to compare the possibility of performing laparoscopic cholecystectomy using two different anesthesia procedures (spinal anesthesia versus general anesthesia).

Methods

The study included 68 patients with symptoms of cholelithiasis examined in the 309th Hospital of PLA from 2006 to 2009. Patients were randomly selected to undergo laparoscopic cholecystectomy with low tension pneumoperitoneum with CO2 under general anesthesia (n=33) or spinal anesthesia (n=35). The study used propofol, fentanyl, rocuronium, sevoflurane and tracheal intubation for general anesthesia and hyperbaric 15 mg bupivacaine and 20 µg fentanyl were used to achieve a sensorial level of T3 for spinal anesthesia. Intraoperative parameters, postoperative pain, complications, recovery, patient satisfaction and cost were compared between both groups.

Results

All surgical procedures were completed with the chosen method with the exception of one case, in which spinal anesthesia was converted to general anesthesia. Shoulder pain was significantly less frequent in the spinal anesthesia group (6%) compared with the general anesthesia group (24%). The level of pain at 2, 4, and 6 h after the procedure under spinal anesthesia was significantly lower than that under general anesthesia. At 12 h both groups had the same evaluation in the visual analogue scale. In the spinal anesthesia group all patients recovered 6 h after surgery, while patients in the general anesthesia group spent more time in recovery. All patients were discharged from hospital after 24 h. In the postoperative evaluation all patients were satisfied with the spinal anesthesia and would recommend this procedure, while only 78.9% of patients were very satisfied in the general anesthesia group. The cost of spinal anesthesia was significantly lower than that of general anesthesia.

Conclusions

Laparoscopic cholecystectomy with low pressure pneumoperitoneum with CO2 can be safely performed under spinal anesthesia. Spinal anesthesia was associated with an extremely low level of postoperative pain, better recovery and lower cost than general anesthesia.

Keywords

Anesthesia, general Anesthesia, spinal Cholecystectomy, laparoscopic Comparative study Pain, postoperative 

ZURÜCKGEZOGEN: Verschiedene Anästhesiemethoden bei laparoskopischer Cholezystektomie

Zusammenfassung

Hintergrund

Mit der vogestellten Studie sollte die Durchführbarkeit einer Cholezystektomie in Spinalanästhesie im Vergleich zur Vollnarkose untersucht werden.

Methode

Es erhielten prospektiv randomisiert 68 Patienten, die sich einer laparoskopischen Cholezystektomie unterziehen mussten, entweder eine Vollnarkose (n=33) mit Fentanyl, Rocuronium und Sevofluran oder aber eine Spinalanästhesie (n=35) mit 15 mg Bupivacain und 20 µg Fentanyl. Bei der Spinalanästhesie wurde eine sensorische Blockade bis T3 angestrebt. Intraoperative Parameter, postoperativer Schmerz, Erholung, Patientenzufriedenheit und Kosten wurden zwischen beiden Gruppen verglichen.

Ergebnis

Alle Operationen wurden mit der gewählten Anästhesiemethode zu Ende geführt, mit Ausnahme von einem Fall, in dem von Spinalanästhesie auf Allgemeinanästhesie gewechselt wurde. Verglichen mit der Allgemeinanästhesiegruppe trat Schulterschmerz in der Spinalanästhesiegruppe seltener auf (24 vs. 6%; p>0,05). Der Schmerz-Level 2, 4 und 6 h nach der Operation war unter Spinalanästhesie signifikant geringer als unter Allgemeinanästhesie. In der Spinalanästhesiegruppe erholten sich alle Patienten 6 h nach der Operation, während die Patienten der Allgemeinanästhesiegruppe mehr Zeit brauchten. Alle Patienten wurden nach 24 h aus dem Krankenhaus entlassen. In der postoperativen Evaluation waren alle Patienten der Spinalanästhesiegruppe zufrieden und würden Spinalanästhesie weiterempfehlen, während nur 78,9% der Patienten der Allgemeinanästhesiegruppe mit ihrer Narkose zufrieden waren. Die Kosten der Spinalanästhesie waren geringer als die für Allgemeinanästhesie.

Schlussfolgerung

Laparoskopische Cholezystektomie kann sicher unter Spinalanästhesie durchgeführt werden. Spinalanästhesie ist mit einem extrem geringen postoperativen Schmerz-Level, einer besseren Erholung und geringeren Kosten als unter Allgemeinanästhesie assoziiert.

Schlüsselwörter

Allgemeinanästhesie Spinalanästhesie Cholezystektomie, laparaskopische Vergleichsstudie Schmerz, postoperativer 

Notes

Conflict of interest

The corresponding author states that there are no conflicts of interest.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Anesthesiology309th Hospital of PLABeijingChina

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