Torres GMC, Sánchez MMP, López LCR, Aguirre EAC, Pérez VNL, Avalos EJR, Contreras TNA, de la Cerda TLF

Language: Spanish
References: 9
Page: 6-12
PDF size: 219.70 Kb.

ABSTRACT

Introduction: Since the emergence of laparoscopic cholecystectomy, general anesthesia has been used, which offers security, nonetheless, spinal anesthesia has reduced mortality, fewer complications and fewer hospital stay days, therefore, spinal anesthesia seems to be the most adequate for minimally invasive surgeries. This experimental study was done with two handling branches: laparoscopic cholecystectomy under general anesthesia or regional with low pressure pneumoperitoneum to evaluate its security and viability. Material and methods: A total of 18 patients were included in our study, nine patients were subject to a laparoscopic cholecystectomy under general anesthesia, and nine under regional anesthesia, getting spinal anesthesia, administrating 15 mg of hyperbaric bupivacaine, and 25 µg of fentanyl. An arterial line was placed on all patients’ radial artery for monitoring. Results: Spinal anesthesia was successfully done on 100% of the patients, none of them required conversion to general anesthesia, there were no significant alterations on evaluations in regards to blood gas alterations and/or constant vitals among both groups, with a better pain control and postsurgical recovery in the group under regional anesthesia. Conclusions: This preliminary study has demonstrated that segmental spinal anesthesia can be used with security and effectiveness in laparoscopic cholecystectomy on healthy patients.

REFERENCES

1. Brunicardi F, Andersen D, Billiar T, Dunn D, Hunter J, Matthews J et al. Schwartz principios de cirugía. 9a ed. México: McGraw-Hill; 2011: 632-638.

2. Fischer J, Bland K. Laparoscopic cholecystectomy in: mastery of surgery. Cap 98. 5a ed. Boston, USA: Lippincott Williams & Wilkins; 2007. 1: 116.

3. Asociación Mexicana de Cirugía General AC, Consejo Mexicano de Cirugía General AC. Colecistitis aguda y crónica. En: Tratado de Cirugía General. Parte II Sección 26 Cap. 18. 2a ed. México: Manual Moderno; 2008: 195-201.

4. Asociación Mexicana de Cirugía General AC, Consejo Mexicano de Cirugía General AC. Historia y evolución de la cirugía endoscópica. En: Tratado de Cirugía General. Parte I Sección 13. 2a ed. México: Manual Moderno: 2008: 195-201.

5. Cunningham A. Anesthetic implications of laparoscopic surgery. Yale J Biol Med. 1998; 71: 551-578.

6. Litynski G. Laparoscopy Between the World Wars: The Barriers to Trans-Atlantic Exchange Spotlighting Heinz Kalk, John C. Ruddock. J Society of Laparoendoscopic Surgeons. 1997; 1(2):185-188.

7. Sinha R, Gurwara AK, Gupta SC. Laparoscopic surgery using spinal anesthesia. JSLS. 2008; 12: 133-138.

8. Cueto-Garcia J, Jacobs M, Gagner M. Laparoscopic surgery. New York: McGraw-Hill; 2003: 21-39.

9. Manoranjan K, Jugal K, Bibhas D, Experience of Laparoscopic Cholecystectomy under spinal anesthesia with low-pressure pneumoperitoneum-prospective study of 300 cases. SaudlJ Gastroenterol. 2011; 17(3): 203-207.