Cholecystectomy with thoracic epidural anesthesia in geriatric patients

Abstract

Objective: To determine the outcome of thoracic epidural anaesthesia in open cholecystectomy procedures of comorbid advanced elderly patients. Study Design: Observational study. Place and Duration of Study: Faculty of Medicine, Karadeniz Technical University Hospital, Trabzon, Turkey during 2014-2019. Methodology: This study included 103 geriatric patients of over 65 years, who underwent open cholecystectomy under thoracic epidural anaesthesia during the study period. Patient files, anaesthesia registration forms, early postoperative followup, and discharge process were retrospective. Results: The mean age of the patients included in the study was 79.42 ± 9.03 years, while the mean operation time was 68.02 ± 17.44 minutes. While only 7 (6.8%) patients had a chronic disease, the number of patients with two or three comorbid diseases was 67 (65%). The number of patients with 4 or more comorbidities was 29 (28.2%). The most common intraoperative complications were hypotension (n = 22, 21.4%) and bradycardia (n = 19, 18.4%). Intraoperative desaturation was observed in 7 (6.8%) patients; and oxygen and bronchodilator therapy was effective. The median discharge time was 6.5 (5.0-8.25) days; whereas, 5 (4.9%) patients died postoperatively. Conclusion: In open cholecystectomy operations on comorbid advanced elderly patients, thoracic epidural anaesthesia can be preferred to general anaesthesia.