Анестезия и клинические исследования
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Comparative Study between General and Spinal Anaesthesia in Laparoscopic Appendectomy

Ahmed Medhat Ahmed Mokhtar Mehanna and Atteia Gad Ibrahim

Background: Laparoscopic appendectomy is rapidly increasing in the treatment of acute appendicitis. Spinal anesthesia has some advantages over general anesthesia in providing analgesia and muscle relaxation while avoiding some of the complications of general anesthesia.

Methods: This comparative study was conducted on 80 patients undergoing laparoscopic appendectomy. Surgeries were randomized into two groups. Group (G) was done under General Anesthesia (40 patients) and group (S) Subarachnoid block group (40 patients).

Results: From 1 min to 12 h post-operative there was significant increase in mean heart rate and mean arterial blood pressure in group G than group S. In group (S) 2.5% was converted to open due to shoulder pain and inappropriate level of anesthesia. The operative time between both groups was insignificant. Shoulder pain was found in 5% of group (S). Mean VAS score was significantly lower at 1, 2, 4 and 12 h with significantly less analgesic requirements in group (S).

Nausea was found in 5% of group (G) had and vomiting in 2.5%. No patients of group (S) had back pain. 5% in group (S) had retention and needed urinary catheterization. Early postoperative mobilization was noticed in group (S).

Conclusion: spinal anesthesia using a combination of 0.5% hyperbaric bupivacaine and a fentanyl provided effective anaesthesia for laparoscopic appendectomy with low-pressure CO2 pneumoperitoneum.