Effectiveness of Anaesthesia for Appendicectomy: comparison of spinal anaesthesia with other modalities being practiced in Emergency Department of Allama Iqbal Memorial Teaching Hospital.

Abstract

Aim: To determine the effectiveness, relative intra and post operative complications, postoperative recovery and cost effectiveness of spinal anaesthesia (SA) /regional anaesthesia (RA) compared with other modalities for appendicectomy. Study Design: Prospective, comparative observational study. Time and Place of study: Department of Anaesthesia and Surgery; Allama Iqbal Memorial Teaching Hospital, Sialkot from 1st August 2016 till 31 July 2017. Methods: All patients undergoing appendectomy in specified time period with ASA (American society of Anesthesiologists) I and ASA II and having completed follow up of 2 months were included in study. Patients having perforated appendix undergoing laprotomy, with known history of Diabetes Mellitus, having ASA III, ASA IV , ASA V, having previous surgery, patients who left against medical advice and those who didn’t completed the follow up of 2 months were excluded from study. Results: Out of 350 patients that were included 328(93.75%f) patients had acute appendicitis while 22(6.28%) of patients doesn’t had acute appendicitis on peroperative diagnosis. Male to female ratio was 1:3.20 Group I – Spinal Anaesthesia included 112(32%) patients, Group II (A) general anaesthesia with intubation included 123(35.14%) patients, while Group II (B) general anaesthesia without intubation included 115(32.85%) patients. Maximum number of patients lies in 11-20 years age group i.e., 186(53.00%). Conclusion: Spinal anaesthesia is a safe, cost effective with minimal per and postoperative complications, efficient and effective modality for appendicectomy in emergency setting as compared to other modalities like general anaesthesia with or without endotracheal intubation.