THORACIC SPINAL ANESTHESIA (TSA) RESULTS, IN UPPER ABDOMINAL SURGERIES

Main Article Content

Imran Hafeez
Kelash Kumar
Khawar Aziz
Zaheer Ahmed
Imran Ali
Ahmeduddin Soomro

Keywords

Thoracic Spinal Anesthesia, Abdominal Surgeries

Abstract

Introduction: Thoracic spinal anesthesia (TSA) is a valuable treatment that can be used for a variety of surgical approaches. The surgeon and the team should be aware that the choice of patient is crucial and that a thorough history and physical examination will determine who is eligible.


Objective: To determine the application of thoracic spinal anesthesia (TSA) in upper abdominal surgeries.


Study design: A cross-sectional study


Place and Duration: This study was conducted in King Abdullah Medical City, Makkah, from May 2021 to May 2022.


Methodology: This study evaluated 17 cases of TSA in admitted patients undergoing laparoscopic surgery and other upper abdominal procedures. Despite its rarity, thoracic spinal anesthesia is proven to be a harmless and current method for a variety of procedures. The treatment has been found to benefit these patients by maintaining hemodynamic stability and decreasing the negative effects associated with general anesthesia.


Results: In this study, there were 10 (58.8%) males and 7 (41.2%) females. The mean age, weight, height, and BMI were 36.71.28 ± 13.9 years, 45.7 ± 4.9 kg, 161.67± 4.1 cm, and 21.1± 3.2 respectively. Two patients out of 17 developed hypotension; one patient reported abdominal pain; and five patients developed pain in the tip of the shoulder intraoperatively. None of the required conversions into general anesthesia were performed; nausea and vomiting were reported in two patients, and none of the patients reported any itching in the study.


Conclusion: With sufficient sedation, thoracic and spinal anesthesia can be administered to normal and even high-risk patients without substantial intraoperative problems and with better postoperative pain control. Giving thoracic spinal anesthesia may be an additional option for certain common surgeries because of enhanced patient safety, a shorter postoperative care stay, and better postoperative pain reduction.

Abstract 366 | Pdf Downloads 204

References

1. Chin KJ, Karmakar MK, Peng P. Ultrasonography of the adult thoracic and lumbar spine for central neuraxial blockade. Anesthesiology. 2011 Jun;114(6):1459-85
2. Sagar A, Soujanya M, Porika R, Dhavanam JY. Anaesthetic management of cases where Thoracic segmental spinal anesthesia a suitable alternative to general anesthesia. Eur J Mol Clin Med. 2022;9(3):10286–92.
3. Ellakany MH. Thoracic spinal anesthesia is safe for patients undergoing abdominal cancer surgery. Anesth Essays Res. 2014;8(2):223–8.
4. Imbelloni LE. Spinal anesthesia for laparoscopic cholecystectomy: Thoracic vs. Lumbar Technique. Saudi J Anaesth. 2014;8(4):477–83.
5. Hamad MA, El-Khattary OAI. Laparoscopic cholecystectomy under spinal anesthesia with nitrous oxide pneumoperitoneum: a feasibility study. Surg Endosc. 2003;17(9):1426–8.
6. Elakany MH, Abdelhamid SA. Segmental thoracic spinal has advantages over general anesthesia for breast cancer surgery. Anesth Essays Res. 2013;7(3):390–5.
7. Lee RA, Zundert AAV, Breedveld P, Wondergem JH, Peek D, Wieringa PA. The anatomy of the thoracic spinal canal investigated with magnetic resonance imaging (MRI). Acta Anaesthesiol Belg. 2007;58(3):163–7.
8. Tummala V, Rao LN, Vallury MK, Sanapala A. A comparative study- efficacy and safety of combined spinal epidural anesthesia versus spinal anesthesia in high-risk geriatric patients for surgeries around the hip joint. Anesth Essays Res. 2015;9(2):185–8.
9. Olawin AM, Das J. Spinal Anesthesia [Internet]. Treasure Island (FL): StatPearls Publishing; 2022.
10. Yousef GT, Lasheen AE. General anesthesia versus segmental thoracicor conventional lumbar spinal anesthesia for patients undergoing laparoscopic cholecystectomy. Anesth Essays Res. 2012;6(2):167–73.
11. Shatri G, Singh A. Thoracic Segmental Spinal Anesthesia. In: StatPearls [Internet. StatPearls Publishing; 2022.
12. Hartmann B, Junger A, Klasen J, Benson M, Jost A, Banzhaf A, Hempelmann G. The incidence and risk factors for hypotension after spinal anesthesia induction: an analysis with automated data collection. Anesth Analg. 2002 Jun;94(6):1521-9, table of contents.
13. Tarkkila P, Isola J. A regression model for identifying patients at high risk of hypotension, bradycardia and nausea during spinal anesthesia. Acta Anaesthesiol Scand. 1992 Aug;36(6):554-8.
14. Carpenter RL, Caplan RA, Brown DL, Stephenson C, Wu R. Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology. 1992 Jun;76(6):906-16.