• George Tzovaras, Frank Fafoulakis, Kostantinos Pratsas, Stavroula Georgopoulou, Georgia Stamatiou, and Constantine Hatzitheofilou.
• Department of Surgery, University of Thessaly Medical School, University Hospital of Larissa, Larissa, Greece. gtzovaras@hotmail.com
• Arch Surg. 2008 May 1;143(5):497-501.

ObjectiveTo compare spinal anesthesia with the gold standard general anesthesia for elective laparoscopic cholecystectomy in healthy patients.DesignControlled randomized trial.SettingUniversity hospital.PatientsOne hundred patients with symptomatic gallstone disease and American Society of Anesthesiologists status I or II were randomized to have laparoscopic cholecystectomy under spinal (n = 50) or general (n = 50) anesthesia.MethodsIntraoperative parameters, postoperative pain, complications, recovery, and patient satisfaction at follow-up were compared between the 2 groups.ResultsAll the procedures were completed by the allocated method of anesthesia, as there were no conversions from spinal to general anesthesia. Pain was significantly less at 4 hours (P < .001), 8 hours (P < .001), 12 hours (P < .001), and 24 hours (P = .02) after the procedure for the spinal anesthesia group compared with those who received general anesthesia. There was no difference between the 2 groups regarding complications, hospital stay, recovery, or degree of satisfaction at follow-up.ConclusionsSpinal anesthesia is adequate and safe for laparoscopic cholecystectomy in otherwise healthy patients and offers better postoperative pain control than general anesthesia without limiting recovery.

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