COMPARISON OF HEMODYNAMIC CHANGES IN THORACIC SEGMENTAL SPINAL ANAESTHESIA AND GENERAL ANAESTHESIA FOR LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Background Laparoscopic cholecystectomy is the standard surgical procedure for symptomatic gallstone disease, typically performed under general anesthesia. Increasing evidence suggests that thoracic segmental spinal anesthesia (TSSA) improves perioperative hemodynamic stability and reduces postoperative complications. Therapeutically, comparing the physiological effects of both methods on intraoperative and postoperative hemodynamic measures is important. Objective: to compare the hemodynamic effects of thoracic segmental spinal anesthesia to general anesthesia in laparoscopic cholecystectomy patients. Secondary outcomes include analgesic requirements, nausea/vomiting, and recovery profile. Methods A 13-month prospective, comparative research study at Patna Medical College & Hospital involved 107 adult patients undergoing elective laparoscopic cholecystectomy. Patients were randomly assigned to two groups: A (n=53) had thoracic segmental spinal anesthesia (TSSA), while B (n=54) received general anesthesia. At regular intervals, hemodynamic parameters like HR, MAP, and SpO₂ were recorded during and after the procedure. Analgesics, recovery time, and side effects like nausea and hypotension were recorded. Results Compared to GA, TSSA resulted in more stable hemodynamic parameters, with significantly reduced MAP and HR oscillations (p < 0.05). TSSA patients needed fewer intraoperative analgesics, recovered faster, and had less postoperative nausea and vomiting. TSSA had more hypotension early in surgery, but vasopressors controlled it. No high spinal block or neurological sequelae were observed. Conclusion Thoracic segmental spinal anesthesia offers a safe and effective alternative to general anesthesia for laparoscopic cholecystectomy, resulting in improved hemodynamic stability, reduced perioperative complications, and faster recovery. TSSA is beneficial for those at risk of general anesthesia.