Khalid Saeed, Naeem Ali, Farzana Mehboob, Ghulam Mustafa.
An experience of mini lap cholecystectomy under spinal anaesthesia.
Rawal Med J Jan ;41(1):27-30.

Objective: We performed this study of mini lap cholecystectomy under spinal anesthesia to assess its safety and benefits in centers where laparoscopic facilities are not available. Methodology: The study was conducted at Department of surgery, Cantonment General Hospital, Rawalpindi, Pakistan from May 2005 to April 2010 and included 630 patients admitted for cholecystectomy. Out of 630 patients, 54 were excluded either due to refusal/failure of spinal anesthesia or loss of follow up. Remaining 576 patients constituted the study. Bupivacaine 0.75% in 2ml dose was used for spinal anesthesia at L2-L3 level. Per operative and postoperative findings were recorded and results were analyzed using SPSS 20. Results: Out of 576 patients, 81.9% were females and 18.1% were males. Mean age for males was 50 years while for females it was 38.5 years. Per operative complications like hypotension was noted in 42 (7.29%), nausea and vomiting in 110 (19%), sinking of heart and bradycardia in 16 (2.77%) patients. Postoperative complications like spinal headache was noted in 30 (5.2%), superficial skin infection in 26 (4.5%) and nausea/vomiting in 18(3.1%) patients. Average hospital stay was 1.5 days. Mean operative time was 45 minutes. Conclusion: Mini lap cholecystectomy under spinal anesthesia is an excellent option as a substitute to laparoscopic cholecystectomy in expert hands. Spinal anesthesia for high risk cases of pulmonary diseases is safe.

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