RT Journal Article
SR Electronic
T1 Thoracic spinal anaesthesia for abdominal surgery in a humanitarian military field hospital: a prospective observational study
JF BMJ Military Health
JO BMJ Mil Health
FD British Medical Journal Publishing Group
SP 26
OP 30
DO 10.1136/bmjmilitary-2022-002075
VO 170
IS 1
A1 Younes Aissaoui
A1 M Bahi
A1 A El Khader
A1 R El Barni
A1 A Belhadj
YR 2024
UL http://militaryhealth.bmj.com/content/170/1/26.abstract
AB 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.Data are available upon reasonable request.