Thoracic epidural anesthesia for gas-free trans-umbilical single port laparoscopic cholecystectomy: a case report

Laparoscopic cholecystectomy (LC) is usually performed under general anaesthesia (GA). With the advancement of surgical and anaesthetic technique, there were many LC have been successfully performed under epidural anaesthesia in recent years. Surgeons in our hospital have performed gas-free trans-umbilical single port laparoscopic cholecystectomy since 2015. However, the description of thoracic spinal epidural anesthesia (TEA) for gas-free trans-umbilical single port laparoscopic cholecystectomy has not been reported yet. The goal of anesthetic management in gas-free trans-umbilical single port laparoscopic cholecystectomy procedures includes achieving an adequate level of sensory blockade without any respiratory compromise, providing good postoperative pain relief, and mild pain at early ambulation. Epidural anaesthesia fulfils all the mentioned criteria and can contribute to quick recovery and thus has been suggested to be a suitable alternative to general anaesthesia for laparoscopic surgeries. We present a case of the successful application of the thoracic epidural anaesthesia combined with laryngeal mask for gas-free trans-umbilical single port laparoscopic cholecystectomy and postoperative pain.