Comparing cholecystectomy in patients with chronic obstructive pulmonary disease under spinal anaesthesia and general anaesthesia
Keywords:
COPD, cholecystectomy, spinal anaesthesiaAbstract
Introduction: The prevalence of Chronic obstructive lung disease has been increased globally. We compared the effectiveness of SA versus GA for open cholecystectomy with regards to post operative pain reduction, analgesia requirement, respiratory complications and length of hospital stay in chronic obstructive lung disease patients. Materials and Methodology: Group 1 (the GA group) received 0.6 mg/kg rocuronium bromide, 2 mg/kg propofol, and 2 μg/kg fentanyl. After 90-120 seconds 100% oxygenation, these patients underwent endotracheal intubation. Maintenance of anaesthesia was performed using 1 – 2% sevoflurane in 50% nitrous oxide/50% oxygen. Group 2 (the SA group) received their anaesthesia while sitting. Patients underwent lumbar puncture using a 25 - gauge needle in the L3-L4 intervertebral space and were given an intrathecal injection of 25 mg fentanyl and 3ml hyperbaric bupivacaine (0.5%), following which they were told to lay supine for 5 minutes. Results: There was no significant difference between the GA and SA groups, postoperative pulmonary functions were impaired more frequently in the GA group, and 4 GA patients required mechanical ventilation. There was no significant difference in operation duration between the SA and GA groups. Conclusion: Cholecystectomy could be performed safely under GA and SA in patients with COPD.
Downloads
References
Kim TH, Lee JS, Lee SW, Oh YM. Pulmonary complications after abdominal surgery in patients with mild-to-moderate chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2016;11:2785–96.
Sinha R, Gurwara AK, Gupta SC. Laparoscopic cholecystectomy under spinal anaesthesia: a study of 3492 patients. J Laparoendosc Adv Surg Tech A. 2009; 19(3):323–7.
Celli BR, MacNee W, Force AET. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004;23(6):932–46.
Gramatica L Jr, Brasesco OE, Mercado Luna A, Martinessi V, Panebianco G, Labaque F, et al. Laparoscopic cholecystectomy performed under regional anaesthesia in patients with chronic obstructive pulmonary disease. SurgEndosc. 2002;16(3):472–5.
Jonnesco T. Remarks on general spinal anaesthesia. Br Med J 1909;2:1935.
Frumin MJ, Schwartz H, Burns J, et al. Dorsal root ganglion blockade during threshold segmental spinal anaesthesia in man. J Pharm Exp Ther1954;112:387–92.
van Zundert AA, Stultiens G, Jakimowicz JJ, et al. Segmental spinal anaesthesia for cholecystectomy in a patient with severe lung disease. Br J Anaesth2006;96:464–6.
Hamad MA, El-Khattary OA. Laparoscopic cholecystectomy under spinal anaesthesia with nitrous oxide pneumoperitoneum: a feasibility study. SurgEndosc. 2003;17:1426–1428.
Tzovaras G, Fafoulakis F, Pratsas K, Georgopoulou S, Stamatiou G, Hatzitheofilou C. Laparoscopic cholecystectomy under spinal anaesthesia: a pilot study. SurgEndosc. 2006 ;20:580–582.
Gupta H, Ramanan B, Gupta PK, Fang X, Polich A, Modrykamien A, et al. Impact of COPD on postoperative outcomes: results from a national database. Chest. 2013;143(6):1599–606.
Sakai RL, Abrao GM, Ayres JF, Vianna PT, Carvalho LR, Castiglia YM. Prognostic factors for perioperative pulmonary events among patients undergoing upper abdominal surgery. Sao Paulo Med J. 2007;125(6):315–21.
Yang CK, Teng A, Lee DY, Rose K. Pulmonary complications after major abdominal surgery: National Surgical Quality Improvement Program analysis. J Surg Res. 2015;198(2):441–9.
Licker M, Schweizer A, Ellenberger C, Tschopp JM, Diaper J, Clergue F. Perioperative medical management of patients with COPD. Int J Chron Obstruct Pulmon Dis. 2007;2(4):493–515.
Hansen G, Drablos PA, Steinert R. Pulmonary complications, ventilation and blood gases after upper abdominal surgery. Acta Anaesthesiol Scand. 1977; 21(3):211–5.
Meyers JR, Lembeck L, O'Kane H, Baue AE. Changes in functional residual capacity of the lung after operation. Arch Surg. 1975;110(5):576–83.
Pursnani KG, Bazza Y, Calleja M, Mughal MM. Laparoscopic cholecystectomy under epidural anaesthesia in patients with chronic respiratory disease. SurgEndosc. 1998;12(8):1082–4.
Ozyuvaci E, Demircioglu O, Toprak N, Topacoglu H, Sitilci T, Akyol O. Comparison of transcutaneous, arterial and end-tidal measurements of carbon dioxide during laparoscopic cholecystectomy in patients with chronic obstructive pulmonary disease. J Int Med Res. 2012;40(5):1982–7.
Iwasaka H, Miyakawa H, Yamamoto H, Kitano T, Taniguchi K, Honda N. Respiratory mechanics and arterial blood gases during and after laparoscopic cholecystectomy. Can J Anaesth. 1996;43(2):129–33.
Hsieh CH. Laparoscopic cholecystectomy for patients with chronic obstructive pulmonary disease. J Laparoendosc Adv Surg Tech A. 2003;13(1):5–9.
Imbelloni LE, Sant'anna R, Fornasari M, Fialho JC. Laparoscopic cholecystectomy under spinal anaesthesia: comparative study between conventional- dose and low-dose hyperbaric bupivacaine. Local Reg Anesth. 2011;4:41–6.
Mehta PJ, Chavda HR, Wadhwana AP, Porecha MM. Comparative analysis of spinal versus general anaesthesia for laparoscopic cholecystectomy: a controlled, prospective, randomized trial. Anesth Essays Res. 2010;4(2):91–5.
Yuksek YN, Akat AZ, Gozalan U, Daglar G, Pala Y, Canturk M, et al. Laparoscopic cholecystectomy under spinal anaesthesia. Am J Surg. 2008; 195(4):533–6.
Pujari VS, SM R, Hiremath BV, Bevinaguddaiah Y. Laparoscopic Cholecystectomy Under Spinal Anaesthesia vs. General Anaesthesia: a prospective randomised study. J Clin Diagn Res. 2014;8(8):NC01–4.
Fischli, A. E., Godfraind, T., & Purchase, I. F. H. (1998). Conclusions and Recommendations. Pure and Applied Chemistry, 70(9), 1863-1865. https://doi.org/10.1351/pac199870091863
Published
How to Cite
Issue
Section
Copyright (c) 2022 International journal of health sciences

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.








