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KMID : 0371420170920040208
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Annals of Surgical Treatment and Research
2017 Volume.92 No. 4 p.208 ~ p.213
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Combined spinal-epidural anesthesia in laparoscopic appendectomy: a prospective feasibility study
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Uzman Sinan
Donmez Turgut
Erdem Vuslat Muslu
Hut Adnan
Yildirim Dogan
Akinci Muzaffer
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Abstract
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Purpose: Laparoscopic appendectomy (LA) is routinely performed under general, not regional anesthesia. This study assessed the feasibility, efficacy, and side effects of combined spinal-epidural anesthesia (CSEA) in LA.
Methods: Thirty-three American Society of Anesthesiologist (ASA) physical status classification grade I patients underwent LA under CSEA. CSEA was performed using the needle-through-needle technique at the L3?L4 interspace. Preoperative and postoperative adverse events related to CSEA, patient satisfaction, and postoperative pain levels were recorded.
Results: LA under CSEA was performed successfully in 33 patients (84.6%). Peroperatively, right shoulder pain was observed in 8 patients (24.1%), abdominal discomfort in 6 (18.2%), anxiety in 5 (15.2%), hypotension in 2 (6.1%) and nausea-vomiting in 1 (3%). In the first 24 hours after LA, headache, urinary retention, right shoulder pain, and postoperative nausea/vomiting (PONV) occurred in 18.1%, 12.1%, 9.1%, and 0% of patients, respectively. In the first 6 hours postoperation, no patients had operation-site pain that required analgesic treatment. Thirty-one patients (94%) evaluated their satisfaction with the procedure as good or moderate.
Conclusion: CSEA is an efficient and suitable anesthesia technique in LA for ASA physical status classification grade I healthy patients. CSEA is associated with good postoperative pain control and the absence of PONV and intubation-associated complications.
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KEYWORD
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Laparoscopy, Spinal anesthesia, Epidural anesthesia, Appendicitis
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