Browsing by Author "Neupane, Biplov"
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Publication Thoracic Segmental Spinal Anesthesia for Laparoscopic Cholecystectomy: A Case Report(Institute of Medicine, 2024) Bajracharya, Nitendra Raj; Joshi, Pankaj; Neupane, Biplov; Shrestha, Reshma; KC, Milan; Bhatta, Prashant; Parajuli, BashudevABSTRACT Laparoscopic surgery is normally performed under general anesthesia. Thoracic segmental spinal anesthesia (TSSA) can be a suitable alternative to general anesthesia for patients with respiratory diseases, as it avoids the risk of general anesthesia. We successfully managed a 74-year-old lady with COPD undergoing elective laparoscopic cholecystectomy with TSSA at T8-T9 interspace using 1.7 ml of hyperbaric bupivacaine 0.5% with 0.3 ml (15mcg) of fentanyl. Some discomfort was managed with 1mg midazolam and 50 mcg fentanyl intravenously. There was no neurological deficit and major hemodynamic fluctuations intra and post-operatively and recovery was uneventful. Keywords: COPD, laparoscopic cholecystectomy, thoracic segmental spinal anesthesia