Anestesia Regional vs General en Colecistectomía Laparoscópica Electiva

Spinal vs General Anesthesia for Laparoscopic Cholecystectomy
Interim Analysis of a Controlled Randomized Trial
George Tzovaras; Frank Fafoulakis; Kostantinos Pratsas; Stavroula Georgopoulou; Georgia Stamatiou; Constantine Hatzitheofilou.
Arch Surg. 2008;143(5):497-501.

Objective To compare spinal anesthesia with the gold standard general anesthesia for elective laparoscopic cholecystectomy in healthy patients.

Design Controlled randomized trial.

Setting University hospital.

Patients One hundred patients with symptomatic gallstone disease and American Society of Anesthesiologists status I or II were randomized to have laparoscopic cholecystectomy under spinal (n = 50) or general (n = 50) anesthesia.

Methods Intraoperative parameters, postoperative pain, complications, recovery, and patient satisfaction at follow-up were compared between the 2 groups.
Results All the procedures were completed by the allocated method of anesthesia, as there were no conversions from spinal to general anesthesia. Pain was significantly less at 4 hours (P < .001), 8 hours (P < .001), 12 hours (P < .001), and 24 hours (P = .02) after the procedure for the spinal anesthesia group compared with those who received general anesthesia. There was no difference between the 2 groups regarding complications, hospital stay, recovery, or degree of satisfaction at follow-up.

Conclusions Spinal anesthesia is adequate and safe for laparoscopic cholecystectomy in otherwise healthy patients and offers better postoperative pain control than general anesthesia without limiting recovery.