Evaluation of segmental thoracic spinal anesthesia for laparoscopic cholecystectomy: Perioperative hemodynamic, analgesic, and recovery outcomes

Background: Laparoscopic cholecystectomy (LC) is conventionally performed under general anesthesia (GA). Segmental thoracic spinal anesthesia (STSA) may provide adequate surgical anesthesia while avoiding airway instrumentation and facilitating post-operative analgesia and recovery. Aims and Objectives: The present study evaluated the efficacy and safety of STSA for elective LC. Materials and Methods: A prospective observational study was conducted among 50 adult patients with American Society of Anesthesiologists physical status I–II undergoing elective LC at Rani Durgavati Medical College, Banda, Uttar Pradesh, from March to September 2025. STSA was administered using 1.5 mL of 0.75% isobaric ropivacaine. Hemodynamic and respiratory parameters, sensory block, analgesic requirements, post-operative pain, recovery, complications, and patient and surgeon satisfaction were assessed. Results: Females constituted 64% of participants, with the 31–40-year age group being the largest (34%). Adequate sensory block was achieved within 5.0±2.0 min. All procedures were completed under STSA without conversion to GA. Supplemental intraoperative analgesia was required in 16%. Bradycardia occurred in 14%, hypotension in 4%, and shoulder discomfort in 16%. No major respiratory or neurological complications occurred. Mean visual analog scale scores were 1.2±0.9 at 3 h and 0.9±0.7 at 24 h. The mean time to first rescue analgesia was 300±85 min, while unaided ambulation occurred at 4.0±1.4 h. Patient and surgeon satisfaction scores ≥4/5 were observed in 94% and 96%, respectively. Conclusion: STSA was a feasible and effective technique for elective LC, providing satisfactory surgical anesthesia, hemodynamic stability, post-operative analgesia, early recovery, and high patient and surgeon satisfaction.