Laparoscopic appendicectomy under spinal anesthesia, a cost effective and efficient approach, a prospective study

Open Access

Abstract

Background: Laparoscopic appendicectomy (LA) is widely accepted as the standard treatment for acute appendicitis and is conventionally performed under general anaesthesia. However, spinal anaesthesia (SA) has emerged as a potential alternative, particularly in resource-limited settings. This study aimed to assess the feasibility, safety, and cost-effectiveness of LA performed under spinal anaesthesia. Methods & Materials: This prospective study was conducted at Brahmanbaria Medical College Hospital from February 2022 to June 2024. A total of 188 patients (108 females, 80 males) aged 12-45 years with ASA grade I-II and clinically diagnosed acute appendicitis were included. All patients underwent laparoscopic appendicectomy under spinal anaesthesia. Patients with complicated appendicitis or contraindications to spinal anaesthesia were excluded. Data regarding operative time, intraoperative and postoperative events, pain scores, and hospital stay were analyzed. Results: The mean age was 25.5 ± 9.25 years, and the mean BMI was 22.55 ± 4.05 kg/m². The mean operative time was 22.8 ± 10.5 minutes, with a total procedure time of 52.1 ± 16.2 minutes. Median hospital stay was 2 days. Intraoperative events included shoulder pain (27.12%), abdominal discomfort (18.61%), anxiety (14.89%), nausea/vomiting (15.42%), and hypotension (9.57%), with no respiratory complications or bradycardia. Postoperative complications were mild, including nausea/vomiting (13.82%), shoulder pain (10.63%), and headache (6.38%), with no urinary retention or wound infections. Pain scores were minimal at 1 hour, peaked at 6 hours, and gradually declined thereafter. All patients reported good satisfaction and favourable cosmetic outcomes. Conclusion: Laparoscopic appendicectomy under spinal anaesthesia is a safe, effective, and economical alternative to general anaesthesia, offering low complication rates, rapid recovery, and significant cost savings.