COMPARISONOF OUTCOME OF APPENDICECTOMY IN SPINAL VS GENERAL ANESTHESIA

Abstract

ABSTRACT
INTRODUCTION: Acute appendicitis is very common surgical disease that mostly leads to a
surgical removal of the appendix OBJECTIVE: To evaluate outcome of open appendicectomy in
spinal versus general anesthesia. STUDY DESIGN: Prospective, observational (comparative)
study design.VENUE AND TIMING: Surgery department in collaboration with department of
anesthesia; Khairpur Medical College Hospital Khairpur mirs from 1
st December 2018 till 31 July
2018. METHODS: All patients between 10 to 50 years of age undergoing appendectomy who has
ASA class I and ASA class II were recruited. Patients having BMI greater than 30, perforated
appendix, history of Diabetes Mellitus, having past history of abdominal surgery, having ASA
g r e a t e r t h a n I I a n d patients who left against medical advice were excluded. RESULTS:
Out of 109 patient 73 (66.97%) patients were male and 36 (33.02%) were female. Male/female
ratio was 2.02:1 Spinal Anaesthesia (group- A) included 64(58%) patients in which 41 (64.06%)
were male and 23 (35.93%) were female. General anaesthesia (Group B) included 45(41.28%)
patients in which 27(60%) were male and 18(40%) were female. 11-20 years age group occupied
maximum number of patients i.e., 63(57.79%). Our study showed mean arterial blood pressures
and pulse rate slightly higher in patients whose appendicectomy was done in general anesthesia as
compared to the patients who were operated under spinal anesthesia while we did not found much
difference in oxygen saturation in both groups. We also found hypotension in 05 (07.81%) patients
of spinal anesthesia group while in 03 (8.33%) patients in general anesthesia group, hypothermia
in 2 (3.12%) patients in spinal group-A while in 8 (22.22%) patients in general anesthesia group
–B. Hypoxemia in 1 (1.5%) patient in spinal group A and 01(2.7%) patient in general anesthesia
group-B was found. There was severe abdominal discomfort in 9 (14.06%) patients in spinal
group-A from which 04 (6.25%) patients were converted to general anesthesia while no abdominal
discomfort was found in general anesthesia group-B. From these study values we found patients
operated under spinal anesthesia have comparatively less per and postoperative complications.
CONCLUSION: Appendicectomy under spinal anesthesia is a comparatively safe with very few
intra and postoperative complications as compared to appendicectomy in general anesthesia.