A Clinical Study of Effectiveness of Spinal Anesthesia for Appendicectomy

Résumé

Introduction: Appendicectomy is conventionally done under general anesthesia. There are limited data about appendicectomy under spinal anesthesia. Spinal anesthesia is regional anesthesia that prevents neurons' pain stimulation to subarachnoid space by using local anesthesia. It has some advantages over general anesthesia. This study aimed to assess the effectiveness of spinal anesthesia for appendicectomy. Methods: This study was conducted in the Department of Anesthesiology of Jalalabad Ragib-Rabeya Medical College Hospital and different clinics of Sylhet city in the years 2017 and 2018. A total of 75 patients were included in the study as per inclusion criteria. Result: Among 75 study subjects, 40 (53.33%) belonged to the age group of 15-25 years, followed by 20 (26.67%) from the age group of 26-35 years, 10 (13.33%) from the age group of 36-45 years and the rest 5 (6.67%) were from the group of 46-55 years of age. 41 (54.67%) patients were male & 34 (45.33%) were female, 35 (46.67%) patients belonged to the BMI range of 16-18 kg/m2 and 40 (53.33%) patients belonged to 18.5-25.25 kg/m2. During the operation, 45 (60.0%) patients developed hypotension, 12 (16.0%) patients developed bradycardia, and 35 (46.67%) patients needed opioid. Concerning postoperative complications, 8 (10.67%) patients experienced nausea & vomiting, only 5 (6.67%) patients had a headache. Among all the study subjects, only 2 patients underwent conversion to G/A. Regarding surgeon's satisfaction, it was very good in the case of 96% of patients and satisfactory in 4% of patients. Regarding the outcomes in pregnant women with appendicitis, 95% of patients experienced very good results and 5% of patients had satisfactory outcomes. Conclusion: Spinal anesthesia was a safe and effective modality for uncomplicated appendicectomy in an emergency setting. It provided a great anesthetic effect during the intra-operative period. The complications that arose were not severe and could be managed easily. It was a safer and better alternative for patients with uncomplicated appendicitis.