Underused approach: subarachnoid block for a laparoscopic cholecystectomy? A case report and discussion of anaesthetic and surgical considerations.
Siang Wei GanAnand RajbhojVenkatesan ThiruvenkatarajanMarkus TrochslerPublished in: BMJ case reports (2021)
We present a case of laparoscopic cholecystectomy with subarachnoid block (SAB) in an opioid-tolerant patient with chronic obstructive pulmonary disease (COPD). A 64-year-old woman presented to the emergency department with acute abdominal pain of biliary colic. Surgery was delayed in favour of conservative management given that she was considered high risk for general anaesthesia. Due to refractory pain, she successfully proceeded to have laparoscopic cholecystectomy with SAB. This case is a timely reminder that SAB is feasible and safe in patients with severe COPD, with the added benefit of increased analgesic effects, fewer postoperative pulmonary complications and quick recovery time.
Keyphrases
- chronic obstructive pulmonary disease
- abdominal pain
- emergency department
- chronic pain
- lung function
- pain management
- neuropathic pain
- minimally invasive
- liver failure
- drug induced
- coronary artery bypass
- pulmonary hypertension
- patients undergoing
- case report
- respiratory failure
- early onset
- risk factors
- aortic dissection
- cystic fibrosis
- spinal cord injury
- spinal cord
- anti inflammatory
- adverse drug
- hepatitis b virus
- atrial fibrillation
- acute coronary syndrome
- postoperative pain