Comparative Analysis of Hemodynamic Responses in Thoracic Segmental Spinal Anes-thesia versus General Anesthesia for Laparoscopic Cholecystectomy

Abstract

Background: Laparoscopic cholecystectomy is the preferred surgical approach for gallbladder removal, offering benefits such as reduced postoperative pain and faster recovery. Anesthesia choice plays a crucial role in influencing surgical outcomes, patient recovery, and satisfaction. While (GA) is traditionally employed, thoracic segmental Spinal Anesthesia (TSSA) has emerged as a viable alternative with potential benefits in hemodynamic stability and recovery.

Aim: This study aims to compare the hemodynamic changes, postoperative pain, and recovery profiles between thoracic segmental SA and GA in patients undergoing laparoscopic cholecystectomy.

Methods: A prospective, randomized controlled trial was conducted involving 90 patients undergoing elective laparoscopic cholecystectomy at a tertiary care center. Participants were randomly assigned to receive either TSSA or GA. Hemodynamic parameters were monitored intraoperatively, and postoperative pain was assessed using the Visual Analog Scale. Recovery markers such as time to ambulation and complication rates were also recorded.

Results: Patients receiving TSSA demonstrated significantly better intraoperative hemodynamic stability and lower postoperative pain scores compared to the GA group. The TSSA group experienced earlier ambulation and fewer postoperative complications such as nausea and vomiting. Statistical analysis showed significant differences with p-values less than 0.05 across most measured outcomes.

Conclusion: TSSA provides superior hemodynamic stability, reduced pain levels, and faster recovery compared to GA in laparoscopic cholecystectomy, making it a beneficial alternative for this procedure.

Recommendations: Further studies should explore the scalability of TSSA in other abdominal surgeries and evaluate long-term outcomes. Hospitals should consider training anesthesia providers in TSSA techniques to broaden its application.

Keywords: Laparoscopic Cholecystectomy, Thoracic Segmental Spinal Anesthesia, General Anesthesia, Postoperative Recovery, Hemodynamic Stability