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Spinal Anaesthesia for Appendectomy: Experience at the University of Benin Teaching Hospital (UBTH), Benin-city, Edo State, Nigeria
Abstract
Background: Appendectomy is the commonest surgical emergency in our hospital. Spinal anaesthesia is one of the anaesthetic techniques for appendectomy; it is simple and safe in experienced hands. We determined the use of spinal anaesthesia for appendectomy and outcome in our centre.
Patients and Methods: This was a retrospective study of all cases of appendectomy performed from April 2007 to September 2009 (thirty months), cases that had spinal anaesthesia were further analysed. Information such as patients’ age, gender, ASA physical health status, PCV, urinalysis, anaesthetic technique, surgery duration, supplemental analgesics, intra-operative complications, and outcome, were obtained from anaesthetic and theatre records.
Results: Five hundred and thirty-three cases of appendectomy were performed, of which 105 (19.7%) patients received spinal anaesthesia while majority (80.1%) of the cases were done under general anaesthesia and 1 (0.2%) patient had epidural anaesthesia. Eighty-four (80%) of the patients who had spinal anaesthesia had intrathecal administration of a combination of 0.5% hyperbaric bupivacaine and an opioid (25μg Fentanyl or 10mg Pethidine), while 21 (20%) had intrathecal administration of 0.5% hyperbaric bupivacaine without opioid. Of the patients who received spinal anaesthesia, 72 (68.6%) had adequate anaesthesia intra-operatively, 25 (23.8%) patients required supplemental analgesics, while 7.6% cases were converted to general anaesthesia. Complications in the intra-operative period such as hypotension, shivering, high block and itching were managed effectively.
Conclusion: The study revealed that use of a combination of 0.5% hyperbaric bupivacaine and an opioid provided effective anaesthesia for appendectomy. We recommend an increasing use of spinal anaesthesia for appendectomy.
Patients and Methods: This was a retrospective study of all cases of appendectomy performed from April 2007 to September 2009 (thirty months), cases that had spinal anaesthesia were further analysed. Information such as patients’ age, gender, ASA physical health status, PCV, urinalysis, anaesthetic technique, surgery duration, supplemental analgesics, intra-operative complications, and outcome, were obtained from anaesthetic and theatre records.
Results: Five hundred and thirty-three cases of appendectomy were performed, of which 105 (19.7%) patients received spinal anaesthesia while majority (80.1%) of the cases were done under general anaesthesia and 1 (0.2%) patient had epidural anaesthesia. Eighty-four (80%) of the patients who had spinal anaesthesia had intrathecal administration of a combination of 0.5% hyperbaric bupivacaine and an opioid (25μg Fentanyl or 10mg Pethidine), while 21 (20%) had intrathecal administration of 0.5% hyperbaric bupivacaine without opioid. Of the patients who received spinal anaesthesia, 72 (68.6%) had adequate anaesthesia intra-operatively, 25 (23.8%) patients required supplemental analgesics, while 7.6% cases were converted to general anaesthesia. Complications in the intra-operative period such as hypotension, shivering, high block and itching were managed effectively.
Conclusion: The study revealed that use of a combination of 0.5% hyperbaric bupivacaine and an opioid provided effective anaesthesia for appendectomy. We recommend an increasing use of spinal anaesthesia for appendectomy.
