Case Reports | Challenge Journal of Perioperative Medicine

Awake laparoscopic cholecystectomy under thoracal segmental spinal anesthesia and intermediate cervical plexus block: A case series

Nezir Yilmaz, Yunus Bozok


DOI: https://doi.org/10.20528/cjpm.2025.02.005
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Abstract


Laparoscopic cholecystectomy (LC) is the preferred approach for treating gallstone disease because of its minimally invasive characteristics. However, factors such as increased intra-abdominal pressure, pneumoperitoneum, and positional changes present significant challenges in anesthetic management. While LC is typically performed under general anesthesia, thoracic segmental spinal anesthesia and cervical plexus block have emerged as effective alternatives in patients for whom general anesthesia poses a high risk. This study reports the use of thoracic spinal anesthesia combined with cervical plexus block in patients where general anesthesia is considered risky. After obtaining informed consent for awake laparoscopic surgery, anesthesia was managed under appropriate monitoring. The combination of spinal anesthesia and cervical plexus block allowed for the successful completion of the procedure, with minimal complications observed in the early postoperative period. In conclusion, thoracic segmental spinal anesthesia and intermediate cervical plexus block offer a safe and effective alternative for patients at high risk for general anesthesia.


Keywords


cervical plexus block; laparoscopic cholecystectomy; regional anesthesia; thoracic spinal anesthesia

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