Central Neuraxial Anaesthesia for Exploratory Laparotomy: A Case Series
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Abstract
Background: Exploratory laparotomy is frequently performed for a variety of abdominal conditions, traditionally under general anaesthesia. However, the use of regional anaesthesia has gained increasing attention due to its potential benefits, including improved postoperative pain management and faster recovery.
Methods: A case series was conducted on 20 adult patients scheduled for exploratory laparotomy over a three-month period, of whom 18 were included following the exclusion of 2 patients with incomplete data. Anaesthetic techniques employed included spinal anaesthesia, epidural anaesthesia, and combined spinal-epidural (CSE) anaesthesia. Key parameters assessed included intraoperative analgesia, intra- and postoperative complications, and patient satisfaction.
Results: Of the 18 included patients, 12 (66.7%) were male and 6 (33.3%) were female, with a mean age of 59 years (range 46–80). Indications included perforated peptic ulcer disease (44.4%), intestinal obstruction (33.3%), mesenteric cyst (11.1%), and ovarian malignancy (11.1%). Epidural anaesthesia was used in 10 patients (55.6%), CSE in 7 (38.9%), and spinal anaesthesia in 1 (5.6%). Four patients (22.2%) required supplemental intraoperative analgesia due to discomfort during bowel manipulation. Transient hypotension occurred in 2 patients (11.1%), whilst 4 (22.2%) experienced postoperative nausea and vomiting. No patient required conversion to general anaesthesia.
Conclusion: Regional anaesthesia for exploratory laparotomy represents a viable alternative to general anaesthesia in carefully selected adult patients, though larger prospective studies are warranted to validate these findings.
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