THORACIC SPINAL ANESTHESIA (TSA) RESULTS, IN UPPER ABDOMINAL SURGERIES
Main Article Content
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.
References
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.