Laparoscopic Cholecystectomy Under Low Thoracic Combined Spinal Epidural Anaesthesia: A Comparative Study Between Isobaric And Hyperbaric Bupivacaine

Loveleen Kour ,Kuldip C.Gupta ,Nandita Mehta,Kuldeep Singh Mehta

Received: Mar. 14, 2026 Accepted: May. 10, 2026 Published: May. 15, 2026

Abstract

Abstract Background: Thoracic spinal anaesthesia has proven its efficacy over general anaesthesia as a routine anaesthetic technique for laparoscopic surgeries. This study aimed to compare the block characteristics of isobaric and hyperbaric bupivacaine in thoracic spinal epidural anaesthesia for laparoscopic cholecystectomies. Materials and methods: The study included 60 ASA I and II patients undergoing elective laparoscopic cholecystectomy, divided randomly into two equal groups. Both the groups were given thoracic combined spinal epidural anaesthesia (CSE) at the T9-T10 / T10-T11 interspace using 1.5 ml of isobaric bupivacaine 0.5% (5 mg/ml) + 25µg (0.5 ml) of fentanyl in group I and 1.5 ml of hyperbaric bupivacaine 0.5% (5 mg/ml) + 25µg (0.5 ml) of fentanyl in group H. Results: The onset of analgesia was comparable in both the groups. In contrast to the longer time taken to reach T4(7.8 min) by hyperbaric bupivacaine which also showed longer motor(220min) than sensory block(117min); isobaric bupivacaine showed lesser time to reach T4(2min) and a shorter duration of motor block (90 min) than the sensory block(160min). Conclusion: By providing a sensory block of longer duration than the motor block isobaric bupivacaine is reflected in a better indication for upper abdominal laparoscopic surgeries.

Keywords: aricity, hyperbaric bupivacaine, isobaric bupivacaine, laparoscopic cholecystectomy, thoracic combined spinal epidural anaesthesia.

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