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. 2022 Feb;32(2):457-462.
doi: 10.1007/s11695-021-05796-x. Epub 2022 Jan 4.

Combined Thoracic Spinal-Epidural Anesthesia for Laparoscopic Sleeve Gastrectomy; One Hundred Case Experience

Wesameldin A Soltan  1 , Ehab Fathy  2 , Mohamed Khattab  2 , Mohamed Saber Mostafa  2 , Haytham Hasan  2 , Ahmed Refaat  2 , Mostafa Ali Mohamed Eltantawy  3 , Hisham Fahmy Mohamed Ziada  3 , Mohamed D Sarhan  2
Affiliations

Combined Thoracic Spinal-Epidural Anesthesia for Laparoscopic Sleeve Gastrectomy; One Hundred Case Experience

Wesameldin A Soltan et al. Obes Surg. 2022 Feb.

Abstract

Background: Obesity is a growingly impacting human health concern. Laparoscopic sleeve gastrectomy (LSG) is an effective treatment for morbid obesity. However, the general anesthesia (GA) used in this major surgery has its documented drawbacks in obese patients with high risk. On the other hand, combined thoracic spinal-epidural anesthesia (CTSEA), a modern regional anesthesia procedure, has the advantages of both spinal and epidural anesthesia but without their shortcomings. This prospective study is a case experience that assesses the feasibility of CTSEA as an anesthesia option for laparoscopic sleeve gastrectomy (LSG).

Methods: A total of 100 patients were recruited for LSG as a management procedure for morbid obesity, which was performed under CTSEA. Perioperative events, functional parameters, and patients' satisfaction scores were recorded.

Results: Our prospective study showed successful use of CTSEA in 99% of the patients, except for one patient (1%) in whom CTSEA was converted into GA due to severe pain and anxiety. Few adverse events occurred and were managed accordingly. The satisfaction score revealed that 94% of the patients were satisfied.

Conclusions: CTSEA was a successful anesthetic alternative procedure for LSG surgery.

Keywords: Morbid obesity, Laparoscopic sleeve gastrectomy, Combined thoracic spinal-epidural anesthesia.

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