Safety and efficacy of thoracic single-shot versus lumbar continuous segmental spinal anesthesia for cholecystectomy: An observational study

Background: Thoracic segmental spinal anesthesia is a safe alternative to general anesthesia (GA) for high-risk patients undergoing cholecystectomy. The procedure can be performed safely using either of two techniques of segmental spinal anesthesia (SSA): Single-shot spinal anesthesia (SSSA) or continuous SSA (CSSA). Aims and Objectives: The aims and objectives of the study are to evaluate the safety and efficacy of SSA in high-risk patients undergoing cholecystectomy using two different techniques – SSSA and CSSA. Materials and Methods: This prospective observational study included 80 patients divided into two groups: Group SSSA (received SSSA, n=40) and Group CSSA (received CSSA, n=40). The study groups were compared regarding hemodynamic stability, respiratory parameters, block characteristics, pain scores, vasopressor consumption, satisfaction scores, and adverse events. Results: Hemodynamic parameters, pain scores, and intraoperative and postoperative analgesia were comparable between the groups. Less performance time, early onset of sensory and motor block, and higher conversion rates to GA were seen in Group SSSA (P<0.05). However, fewer episodes of hypotension were seen in the CSSA group. The satisfaction scores were also higher in Group CSSA (P<0.05). Conclusion: Both techniques of SSA are safe and effective in high-risk patients undergoing cholecystectomy, with CSSA offering added advantages in extended surgeries and titrating local anesthetic dose while maintaining hemodynamic stability.