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Underused approach: subarachnoid block for a laparoscopic cholecystectomy? A case report and discussion of anaesthetic and surgical considerations
  1. Siang Wei Gan1,
  2. Anand Rajbhoj2,3,
  3. Venkatesan Thiruvenkatarajan2,3 and
  4. Markus Trochsler1
  1. 1Discipline of Surgery, The University of Adelaide, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
  2. 2Department of Anaesthesia, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
  3. 3Discipline of Acute Care Medicine, The University of Adelaide, Adelaide, South Australia, Australia
  1. Correspondence to Dr Siang Wei Gan; gansiangwei{at}


We present a case of laparoscopic cholecystectomy with subarachnoid block (SAB) in an opioid-tolerant patient with chronic obstructive pulmonary disease (COPD). A 64-year-old woman presented to the emergency department with acute abdominal pain of biliary colic. Surgery was delayed in favour of conservative management given that she was considered high risk for general anaesthesia. Due to refractory pain, she successfully proceeded to have laparoscopic cholecystectomy with SAB. This case is a timely reminder that SAB is feasible and safe in patients with severe COPD, with the added benefit of increased analgesic effects, fewer postoperative pulmonary complications and quick recovery time.

  • general surgery
  • anaesthesia
  • biliary intervention

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  • Contributors MT, SWG and AR operated on the case. SWG wrote the manuscript. AR, VT and MT contributed to critical analysis of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.