Spinal Anesthesia versus General Anesthesia for open cholcystectomy: Comparison of PERI-operative and post-operative events

Objective: To study perioperative and postoperative events as well as feasibility, effectiveness, safety of patient and surgeons satisfaction for open cholecystectomy under spinal anesthesia (SA) compared to General Anesthesia (GA). Material and Methods: All admitted and consented patients of grade ASA I and ASA II of either sex with diagnosed cholelethiasis for elective open chlecystectomy randomly divided into 2 groups SA group received spinal anesthesia (SA) using 3.00 ml to 3.5 ml of 0.5% hyperbaric Bupivacane intrathecally and GA group received propofol, Fentanyl Citrate, Atracurium and Halothane during open Cholecystectomy. Other drugs used only to manage anxiety, pain, nausea and vomiting, respiratory complication and for haemodynamic stability. All open chlolecystectomy performed by right oblique incision. Intraoperative and postoperative events were observed for 2 days. Main points of study were. Intraoperative complications (Hypotension, bradycardia, Nausea/Vomiting Breathing Difficulty, Patients and Surgeons satisfactions), Post-operative painfree interval, PONV and requirement of analgesia. Result: 200 patients with diagnosed cholelithiasis for open chlecystectomy admitted from july2016 to December 2017 in which 150 patients received adequate spinal anesthesia and 50 patients were preferred for GA. INTRA-OPERATIVELY in SA group 18 patients suffered from respiratory difficulty which was relieved by 100% O 2 with ventimask, 39 patients presented with hypotension managed by given injection Mephentermine, only 2 patients received injection Ephidrine, 12 patients presented with nausea and vomiting treated with antiemetic(Injection Ondensetron), 22 experienced pain, injection tramadol was given for pain relief. POST-OPERATIVELY: Both groups of patients were observed for pain free interval and PONV. Conclusion: Patients undergoing for uncomplicated open Cholecystectomy under spinal-anesthesia is safe and effective technique than G.A. interms of intraoperative events, post-operative analgesia, PONV, cost effective and in view of surgeons and patients satisfaction.