Spinal Anesthesia in Laparoscopic Cholecystectomy: A Cohort Study of 1762 Cases in Southeastern Mexico

Abstract

Spinal anesthesia is a valuable resource in abdominal surgery, which has been used in cholecystectomy. This study aims to evaluate the 14-year experience with the use of spinal anesthesia in laparoscopic cholecystectomy at two hospitals in Southeast Mexico. Spinal anesthesia was applied to 1762 patients that underwent laparoscopic cholecystectomy. The variables analyzed were anthropometric characteristics; risk factors; biochemical parameters; the American Society of Anesthesiologists risk and physical status classification system; perioperative respiratory and heart rate, mean blood pressure, and oxygen saturation level; anesthesia/surgery duration; adverse effects; postoperative complications; hospital stay; and degree of satisfaction. Descriptive statistics of central tendency and dispersion were used, employing the IBM-SPSS version 25.0 program. Mean patient age was 48.8 years (SD 23.45), 77.75% of patients were woman, 44.89% had general risk factors, mean body mass index was 28.9 kg/m2 (SD 3.96), 78.35% of patients had normal preoperative laboratory tests, 3.86% had hyperglycemia, and 16.68% had dyslipidemia; anesthesia/surgery duration was 63.36 min (SD 12.14), and 1.42% of patients had conversion to general anesthesia; heart rate, mean blood pressure, respiration rate, and oxygen saturation level had no significant changes. Postoperatively, 1.42% of patients had headache, 3.18% nausea, 2.44% vomiting, and 2.89% urinary retention. Mean hospital stay was 25.81 h (SD 13.80), 14% of patients had minor complications, and 2 cases had bile duct injury that required surgical reconstruction. There were no deaths. Patient satisfaction was excellent in 92.4% of cases. Results confirm that spinal anesthesia in laparoscopic cholecystectomy is safe, reliable, and feasible.