Conventionally General anaesthesia remains the choice for the majority of open abdominal
surgical procedures, and regional anaesthesia is preferred only for patients who are at high
risk under general anaesthesia . The main reason for selecting spinal anaesthesia as the
first choice for laparoscopic cases was its advantages over general anaesthesia which include
uniform total muscle relaxation, a conscious patient, economical, relatively uneventful
recovery, pain free early postoperative period and the protection from potential
complications of general anaesthesia. The main debatable point, however, seems to be the
status of respiratory parameters among the two modes of anaesthesia during laparoscopic
surgery. In this context it can be stated that spontaneous physiological respiration during
spinal anaesthesia would always be better than an assisted respiration as in general
anaesthesia.
The pneumo-peritoneum induced rise in intra-abdominal pressure including pressure on the
diaphragm and carbon dioxide induced peritoneal irritation are the factors to be considered