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Spinal Anaesthesia for Laparoscopic Cholecystectomy in Patient with Chronic Obstructive Pulmonary Disease | ||
| IRAQI JOURNALOF COMMUNITY MEDICINE | ||
| Article 1, Volume 26, Issue 1, 2013, Pages 72-74 | ||
| Author | ||
| Asaad Kadhim Nazeer | ||
| Abstract | ||
| CASE REPORT Laparoscopic cholecystectomy has become firmly established as the method of choice for the treatment of asymptomatic gallstone because of obvious advantages of minimally invasive character of the procedure associated with less pain, reduced hospital stay, and earlier returns to daily activities. The procedure usually necessitates general anaesthesia and endotracheal intubation to prevent aspiration and respiratory difficult due to pneumoperitoneum. [1-2] There are sporadic references about cholecystectomy under epidural anaesthesia or spinal anaesthesia for special patients such as pregnant woman or patients with chronic obstructive airway disease with high risk for general anaesthesia. [3-4] Here we are presenting in this article a case of laproscopic cholecystectomy done under spinal anaesthesia. Mr. Ramathan Jumaa a Sixty years old, male patient diagnosed as acute cholecystitis with Gall bladder stones, were admitted for Laparoscopic cholecystectomy. He had chronic obstructive pulmonary disease with atelectasis, ex smoker years ago. Although there was no problem in carrying out daily life, Preoperative chest X-ray showed (prominent bronchopulmonary marking .clear both costophrenic angles, lower zone atelectasis, normal cardiac shadow and aorta. Nothing significant in Echocardiography report. There were no abnormal findings on preoperative blood test except increased direct bilirubin. Physician consultation reported if the surgery was to be performed under general anaesthesia a risk of general anaesthesia exist, postoperative complications could be anticipated. Thus, we decided to take spinal anaesthesia after discussing the option with the patient and his guardians | ||
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