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Abstract
Application for ESRA Abstract Prizes: I apply as an Anesthesiologist (Aged 35 years old or less)
Background and Aims Laparoscopic cholecystectomy is a minimally-invasive surgery commonly by general anesthesia. Literature suggests that the use of segmental thoracic spinal anesthesia is an effective anesthesia for these types of procedure and is known for adequate pain relief and reduced opioid requirements. This case report aims to discuss the application of segmental thoracic spinal anesthesia for laparoscopic cholecystectomy.
Methods A 59-year-old ASA II female was scheduled for laparoscopic cholecystectomy. Segmental thoracic spinal anesthesia was given using a mixture of Bupivacaine isobaric 5 mg and bupivacaine hyperbaric 2.5 mg, with the following adjuvants— Fentanyl 25 mcg, Ketamine 20 mg, and Dexmedetomidine 10 mcg injected slowly at the T8-T9 interspace using a gauge 23 spinal needle via midline approach. No recorded paresthesias or any problems during puncture or injection of anesthetic were encountered.
Prescanning and administration of thoracic spinal anesthesia at T8-T9 interspace
Stable vital signs and patient maintained comfortable during insufflation
Postoperatively, patient is awake, comfortable, with Bromage 0
Results After confirming the desired block height of T2, surgery was started. The procedure commenced without any complications. Patient remained comfortable, easily arousable, and responsive during the whole operation and did not require additional sedation intraoperatively. The procedure lasted 2 hours and 9 minutes, with no complaints of poor muscle relaxation from the surgical team. Post-operatively, the patient’s vital signs were well within normal range, and she had no subjective complaints. The patient is also Bromage 0 immediately after the surgery and has no motor or sensory deficits.
Conclusions Segmental thoracic spinal anesthesia may be a viable option for regional anesthesia in laparoscopic cholecystectomy. It provides effective pain relief, reduces opioid use, and minimizes side effects.