B. Nirmala Devi1, Surisetty Sreenivasa Rao2, Raju Bhukya3
BACKGROUND
We wanted to compare the effects of general anaesthesia and regional
anaesthesia in cases posted for laparoscopic appendicectomy and also compare
various parameters like hemodynamic changes, postoperative analgesia, and
postoperative complications in both the techniques.
METHODS
After obtaining permission from scientific and ethical committee of SVMC, Tirupati,
we conducted the study on 60 patients attending SV Medical College, Tirupati from
September 2018 to August 2019, who were in ASA GRADE 1 & 2, and posted for
laparoscopic appendicectomy. We divided them into two groups Group - S – those
who received spinal anaesthesia & Group - G – those who received general
anaesthesia.
RESULTS
60 patients of ASA 1 and 2 were taken up for laparoscopic appendicectomy from
September 2018 to August 2019. Out of 60 patients, 30 patients were grouped
under Group - S, Other 30 patients grouped under Group - G. Intraoperative vitals,
including blood pressure, heart rate, oxygen saturation, and respiratory rate and
end-tidal CO2 levels, were within baseline values, whereas postoperative analgesia
was better in Group - S than Group - G. There were 3 patients in the spinal group
who developed postoperative hypotension and were managed with injection
mephentermine sulphate. Out of 30 in each group, 11 patients in spinal, and 22
patients in GA group developed postoperative nausea and vomiting, which
subsided with antiemetics. There were 4 patients in spinal, and 3 patients in the
GA group who complained of shoulder tip pain in the postoperative period. Patients
had minimal pain and no requirement of analgesia in the initial 3 hours of the
postoperative period in the spinal group.
CONCLUSIONS
Patients who underwent laparoscopic appendicectomy under spinal anaesthesia
(Group - S) showed significant postoperative analgesia (P - value < 0.05) and
better haemodynamic stability than the patients who underwent laparoscopic
appendicectomy under general anaesthesia (Group - G), But alertness for any
emergency by anaesthesiologist was more needed in spinal anaesthesia than
general anaesthesia because airway was not protected, and patient was taking
spontaneous respirations.
