Comparing laparoscopic cholecystectomy in patients with chronic obstructive pulmonary disease under spinal anesthesia and general anesthesia.
BACKGROUND
Epidemiological data demonstrate that the worldwide prevalence of chronic obstructive pulmonary disease is increasing. These patients have an increased risk of mortality and morbidity and have constant limitations in airflow. Comparing laparoscopic cholecystectomy (LC) in patients with chronic obstructive pulmonary disease (COPD) under spinal anesthesia (SA) and general anesthesia (GA).


METHODS
We prospectively evaluated COPD patients who underwent laparoscopic cholecystectomy under general anesthesia (Group 1, n = 30) or spinal anesthesia (Group 2, n = 30) in our clinic between January 2016 and January 2018. Patients with COPD were further divided into groups according to their preoperative stages (Stage 1-4). Intraoperative vital findings, postoperative pain, complications, and length of hospitalization were compared between the general (GA) and spinal anesthesia (SA) groups.


RESULTS
The mean age of the patients in the GA group was 61.0 ± 6.7 years and was 61.0 ± 7.7 years in the SA group. In the GA and SA groups, the mean ASA score was 2.8 ± 0.6 and 2.9 ± 0.6, respectively, the mean operation duration was 31.7 ± 5.1 and 30.6 ± 5.1 min, respectively, and the length of hospitalization was 3.2 ± 1.7 and 1.5 ± 0.5 days, respectively. The partial carbon dioxide rates (PaCO2) at the postoperative 5th and 20th minutes were lower in the SA group than in the GA group. Further, the requirement for postoperative analgesia was lower in the SA group, and the length of hospitalization was significantly shorter in the SA group. There was no significant difference between the two groups in terms of operation duration.


CONCLUSION
Laparoscopic cholecystectomy is a rather safe procedure for COPD patients under general and spinal anesthesia. However, spinal anesthesia is preferred over general anesthesia as it has better postoperative analgesia and causes no impairment of pulmonary functions.
['Bayrak|Mehmet|M|http://orcid.org/0000-0001-8407-0169', 'Altıntas|Yasemin|Y|']
D000368:Aged D000554:Ambulatory Care Facilities D000768:Anesthesia, General D000775:Anesthesia, Spinal D017081:Cholecystectomy, Laparoscopic D005260:Female D006760:Hospitalization D006801:Humans D008297:Male D008875:Middle Aged D010149:Pain, Postoperative D011184:Postoperative Period D015995:Prevalence D011446:Prospective Studies D029424:Pulmonary Disease, Chronic Obstructive
Laparoscopic Cholecystectomy Spinal anesthesia COPD Regional anesthesia