Feasibility of Local Anaesthesia in Various Upper Abdominal Surgical Procedures; A Tertiary Care Hospital Study

Abstract

Background: This study was conducted to evaluate the feasibility of local anesthesia (LA) instead of general anesthesia (GA) in upper gastrointestinal abdominal procedures including open gastrostomy, gastrojejunostomy, gastroduodenal disjunction, jejunostomy and traction esophageal stenting. Materials and Methods: This study was conducted at Thoracic surgery department, Nishtar Hospital Multan, Pakistan from September,1st-December,31st,2020. Out of 147 patients 80 and 67 patients were operated under LA and GA respectively. Age, BMI, gender, procedure performed, etiology, mean time, stay in recovery, PONV, postoperative pain at 4, 8, 12 hours, postoperative sedation and discomfort, within 3-and 7-days postoperative mortality were documented and compared between the two groups. Results: Mean age of the patients in group LA was significantly higher as compared to group GA(p<0.001). Procedure time was 30.06±12.01minutes and 34.42±11.76minutes (p=0.029), mean duration of stay in recovery was 2.31±5.68minutes and 18.80±6.40minutes(p<0.001) in group LA and GA, respectively(p=0.029). Postoperative discomfort was also higher in group GA as compared to group LA(p=0.001). The incidence of PONV was 12.5% and 35.8% in group LA and GA, respectively(p=0.001). Complaint of postoperative pain was 16.2% and 37.3% at 4 hours(p=0.004); 18.8% and 35.8% at 8 hours(p=0.020); and 21.2% and 26.9% at 12 hours(p=0.426) in group LA and GA, respectively. Conclusion: For performing various upper abdominal procedures, LA is safe for the patients who are medically unfit for GA. Moreover, LA is associated with lesser adverse effects as compared to GA. Patient is more comfortable and there is better pain relief in early postoperative period.