Background: Cholecystectomy is performed either as open or laparascopic cholecystectomy. Despite of a number of peri-operative and post-operative benefits of laparascopic cholecystectomy, the older and more invasive open cholecystectomy is still in frequent practice for various reasons. Though general anaesthesia is regarded as the gold standard anaesthetic technique, alternatives to it such as spinal anaesthesia, with its advantages, outweighs general anaesthesia. Spinal anaesthesia, therefore, could be a safe and effective anaesthetic procedure over general anaesthesia for open cholecystectomy.

Methods: After the approval from the hospital ethical committee and written consent received from the patients, 120 patients with uncomplicated symptomatic gallstone disease undergoing open cholecystectomy and complying with ASA I or II physical status, aged between 18 and 70 years of either sex, and BMI ≤ 30 kg/m² were enrolled for the study. They were randomly categorized into SA group (received spinal anaesthesia) and GA group (received general anaesthesia), each group containing 60 patients. Intra-operative events and post-operative events were observed up to 48 hours post-surgery and compared between the groups. Data are represented in percentage, mean with standard deviation and median. Statistical analysis was done using independent t-test and Mann-Whiteney U test.

Results: Spinal anaesthesia is safe and effective in pain management post open cholecystectomy. The pain-free interval in SA group was 4 hours as compared to 30 minutes in GA group. Majority (90%) in SA groups were managed with intramuscular diclofenac whereas majority in GA group were managed with intravenous pethedine. Intra-operatively, SA group had more cases of haemodynamic instability than GA group, which were easily managed in both the groups. The differences in the incidence of post-operative nausea and vomiting and the days of hospital stay between the groups were not significant.

Conclusion: Spinal anaesthesia is safe and more effective than general anaesthesia for uncomplicated open cholecystectomy in terms of peri-operative events, in reducing post-operative pain, and in terms of surgeon’s satisfaction as well.