Publication:
Thoracic Segmental Spinal Anesthesia for Laparoscopic Cholecystectomy: A Case Report

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ABSTRACT 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

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Nitendra Raj Bajracharya1, Pankaj Joshi1, Biplov Neupane1, Reshma Shrestha1, Milan KC2, Prashant Bhatta1, Bashudev Parajuli1 1Department of Anesthesiology, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj, Kathmandu, Nepal 2Department of General Surgery, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj, Kathmandu, Nepal

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COPD, laparoscopic cholecystectomy, thoracic segmental spinal anesthesia

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