Cholecystectomy with Thoracic Epidural Anesthesia in Geriatric Patients

J Coll Physicians Surg Pak. 2021 Apr;30(4):445-449. doi: 10.29271/jcpsp.2021.04.445.

Abstract

Objective: To determine the outcome of thoracic epidural anaesthesia in open cholecystectomy procedures of comorbid advanced elderly patients.

Study design: Observational study.

Place and duration of study: Faculty of Medicine, Karadeniz Technical University Hospital, Trabzon, Turkey during 2014-2019.

Methodology: This study included 103 geriatric patients of over 65 years, who underwent open cholecystectomy under thoracic epidural anaesthesia during the study period. Patient files, anaesthesia registration forms, early postoperative follow-up, and discharge process were retrospective.

Results: The mean age of the patients included in the study was 79.42 ± 9.03 years, while the mean operation time was 68.02 ± 17.44 minutes. While only 7 (6.8%) patients had a chronic disease, the number of patients with two or three comorbid diseases was 67 (65%). The number of patients with 4 or more comorbidities was 29 (28.2%). The most common intraoperative complications were hypotension (n = 22, 21.4%) and bradycardia (n = 19, 18.4%). Intraoperative desaturation was observed in 7 (6.8%) patients; and oxygen and bronchodilator therapy was effective. The median discharge time was 6.5 (5.0-8.25) days; whereas, 5 (4.9%) patients died postoperatively.

Conclusion: In open cholecystectomy operations on comorbid advanced elderly patients, thoracic epidural anaesthesia can be preferred to general anaesthesia. Key Words: Geriatrics, Cholecystectomy, Anesthesia, Thoracic epidural, Comorbidity.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anesthesia, Epidural* / adverse effects
  • Anesthesia, General
  • Cholecystectomy
  • Humans
  • Retrospective Studies
  • Turkey / epidemiology