Background Providing safe and effective anaesthesia in the context of humanitarian medicine is always a challenging situation. Spinal anaesthesia, and in particular its thoracic approach, represents a promising technique for such a limited-resource environment. This prospective observational study investigated the feasibility of thoracic spinal anaesthesia (TSA) for abdominal surgery in a field-deployed military hospital.
Materials and methods We included adults scheduled for elective open cholecystectomy in a field hospital. Patients received TSA at the T9–T10 level. The primary outcomes were the feasibility of surgery under TSA and the haemodynamic/respiratory stability of this anaesthetic technique. The secondary outcomes included patient satisfaction and surgeon comfort regarding the anaesthesia technique and postoperative events (nausea and vomiting, urinary retention, postdural puncture headache).
Results Surgery was performed successfully in 61 patients under TSA (90% female, 53±13 years old). Intraoperative pain scores were low, with a median Numeric Rating Scale score of 0 (IQR 0–2). Surgeon and patient satisfaction scores were excellent. The haemodynamic and respiratory parameters remained stable throughout the surgery. The incidence of postoperative events was low (nausea/vomiting=8%). None of our patients presented with postdural puncture headache or urinary retention.
Conclusion TSA could be an effective anaesthetic technique for abdominal surgery in the context of a field hospital or austere environment.
- adult anaesthesia
- hepatobiliary disease
- public health
- adult surgery
- hepatobiliary surgery
Data availability statement
Data are available upon reasonable request.
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Contributors YA designed the study, performed spinal anaesthesia, analysed the data, was a major contributor to writing the manuscript, and acts as the guarantor of the study. MB analysed the data and revised the manuscript. AEK performed the surgeries and analysed the data. REB performed the surgeries, designed the study and analysed the data. AB performed spinal anaesthesia, analysed the data and contributed to writing the manuscript. All authors read and approved the final manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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