Segmental Spinal Anaesthesia for Laparoscopic Cholecystectomy in Situs Inversus Patient: A Case Report
Situs inversus is a rare congenital anomaly and presents with transposition of abdominal and thoracic viscera to the opposite side, including the heart and gallbladder. Laparoscopic Cholecystectomy (LC) is the gold standard for chronic cholelithiasis and has been reported in patients with situs inve...
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JCDR Research and Publications Private Limited
2025-01-01
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| author | Richa Chandra Gaurav Misra Navneeta Bisht Gopal Dutta Sumit Khandelwal |
| author_facet | Richa Chandra Gaurav Misra Navneeta Bisht Gopal Dutta Sumit Khandelwal |
| author_sort | Richa Chandra |
| collection | DOAJ |
| description | Situs inversus is a rare congenital anomaly and presents with transposition of abdominal and thoracic viscera to the opposite side, including the heart and gallbladder. Laparoscopic Cholecystectomy (LC) is the gold standard for chronic cholelithiasis and has been reported in patients with situs inversus under General Anaesthesia (GA). Segmental Spinal anaesthesia (SS) has been gaining popularity as a safe alternative to GA in high-risk patients and for LC as well. Present case is of a 48-year-old male with situs inversus, dextrocardia without any other cardiopulmonary anomaly, and short stature who was electively operated on under the SS for chronic cholelithiasis electively. The patient was aware of his congenital condition and preferred awake anaesthesia. After a multidisciplinary discussion involving surgery, cardiology and the anaesthesia team the patient was operated on with LC successfully under SS with isobaric levobupivacaine and fentanyl through T8-9 space. The intraoperative and postoperative periods were uneventful. Present case conclude that SS can provide considerable safety in well-investigated patients who pose a risk for GA due to various factors, such as altered anatomy, birth abnormalities associated with cardiac and pulmonary risk and difficult airways. This case report can be used as a reference for the preferred use of SS instead of GA in such cases. |
| format | Article |
| id | doaj-art-6f0232cc32384bc5913a9112e905d0cc |
| institution | Kabale University |
| issn | 2249-782X 0973-709X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JCDR Research and Publications Private Limited |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj-art-6f0232cc32384bc5913a9112e905d0cc2025-01-27T11:15:32ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-01-011901070910.7860/JCDR/2025/73450.20535Segmental Spinal Anaesthesia for Laparoscopic Cholecystectomy in Situs Inversus Patient: A Case ReportRicha Chandra0Gaurav Misra1Navneeta Bisht2Gopal Dutta3Sumit Khandelwal4Professor, Department of Anaesthesia, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India.Associate Professor, Department of Anaesthesia, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India.Senior Resident, Department of Anaesthesia, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India.Consultant Surgeon, Department of General Surgery, GD Hospital, Bareilly, Uttar Pradesh, India.Consultant Cardiologist, Department of Cardiology, Sai Sukhda Hospital, Bareilly, Uttar Pradesh, India.Situs inversus is a rare congenital anomaly and presents with transposition of abdominal and thoracic viscera to the opposite side, including the heart and gallbladder. Laparoscopic Cholecystectomy (LC) is the gold standard for chronic cholelithiasis and has been reported in patients with situs inversus under General Anaesthesia (GA). Segmental Spinal anaesthesia (SS) has been gaining popularity as a safe alternative to GA in high-risk patients and for LC as well. Present case is of a 48-year-old male with situs inversus, dextrocardia without any other cardiopulmonary anomaly, and short stature who was electively operated on under the SS for chronic cholelithiasis electively. The patient was aware of his congenital condition and preferred awake anaesthesia. After a multidisciplinary discussion involving surgery, cardiology and the anaesthesia team the patient was operated on with LC successfully under SS with isobaric levobupivacaine and fentanyl through T8-9 space. The intraoperative and postoperative periods were uneventful. Present case conclude that SS can provide considerable safety in well-investigated patients who pose a risk for GA due to various factors, such as altered anatomy, birth abnormalities associated with cardiac and pulmonary risk and difficult airways. This case report can be used as a reference for the preferred use of SS instead of GA in such cases.https://www.jcdr.net/articles/PDF/20535/73450_CE(Ra1)_F(Sh)_QC(SD_OM)_PF1(AG_SL)_PFA(SL)_PN(SL).pdfdextrocardiaisobariclevobupivacaineshort stature |
| spellingShingle | Richa Chandra Gaurav Misra Navneeta Bisht Gopal Dutta Sumit Khandelwal Segmental Spinal Anaesthesia for Laparoscopic Cholecystectomy in Situs Inversus Patient: A Case Report Journal of Clinical and Diagnostic Research dextrocardia isobaric levobupivacaine short stature |
| title | Segmental Spinal Anaesthesia for Laparoscopic Cholecystectomy in Situs Inversus Patient: A Case Report |
| title_full | Segmental Spinal Anaesthesia for Laparoscopic Cholecystectomy in Situs Inversus Patient: A Case Report |
| title_fullStr | Segmental Spinal Anaesthesia for Laparoscopic Cholecystectomy in Situs Inversus Patient: A Case Report |
| title_full_unstemmed | Segmental Spinal Anaesthesia for Laparoscopic Cholecystectomy in Situs Inversus Patient: A Case Report |
| title_short | Segmental Spinal Anaesthesia for Laparoscopic Cholecystectomy in Situs Inversus Patient: A Case Report |
| title_sort | segmental spinal anaesthesia for laparoscopic cholecystectomy in situs inversus patient a case report |
| topic | dextrocardia isobaric levobupivacaine short stature |
| url | https://www.jcdr.net/articles/PDF/20535/73450_CE(Ra1)_F(Sh)_QC(SD_OM)_PF1(AG_SL)_PFA(SL)_PN(SL).pdf |
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