A Comparative Study on Spinal Versus General Anesthesia for Laparoscopic Cholecystectomy

Abstract

Background: Laparoscopic cholecystectomy (LC) is the gold standard for symptomatic cholelithiasis. While general anesthesia (GA) is conventionally used, spinal anesthesia (SA) is emerging as a viable alternative, potentially offering advantages in a resource-constrained setting. Objective: To compare the intraoperative and postoperative outcomes of spinal anesthesia versus general anesthesia for patients undergoing laparoscopic cholecystectomy. Methods: This prospective comparative study was conducted at Community-Based Medical College, Bangladesh, from April to September 2025. Eighty patients scheduled for elective LC were purposively selected and equally divided into SA (n=40) and GA (n=40) groups. Standardized protocols were followed. Data on intraoperative hemodynamics, postoperative pain (Visual Analog Scale), time to first analgesia, ambulation, oral intake, hospital stay, and complications were collected. Results: The analysis revealed a comparable demographic profile between groups. The spinal anesthesia cohort demonstrated significantly lower postoperative pain scores at 2, 6, and 12 hours (p<0.001) and a prolonged time to first analgesic request (p<0.001). Recovery milestones, including time to ambulation and oral intake, were achieved faster with spinal anesthesia (p<0.01). Furthermore, postoperative nausea and vomiting were significantly less frequent (10% vs. 32.5%, p=0.013). Conclusion: Spinal anesthesia is a safe and effective alternative for laparoscopic cholecystectomy, providing superior analgesia, fewer opioid-related side effects, and a faster early recovery. It is a highly recommended technique for community-based surgical practice.