ASSESSMENT OF SURGICAL OUTCOME OF SPINAL VERSUS GENERAL ANESTHESIA IN PATIENTS UNDERGOING APPENDECTOMY FOR ACUTE APPENDICITIS AT WALLAGA UNIVERSITY COMPRHENSIVE SPECIALIZED HOSPITAL, NEKEMTE, OROMIA, ETHIOPIA, A Retrospective Comparative Cross-sectional Study

ABSTRACT

Background: Acute appendicitis is the most common surgical emergency and appendectomy is a standard surgical procedure. In local clinical setting, anesthetic selection for appendectomy remains clinician-driven without local evidence. Spinal anesthesia may offer advantages over general anesthesia, but comparative data are lacking.

Objective: To assess surgical outcomes of spinal versus general anesthesia in patients undergoing appendectomy for acute appendicitis at Wallaga University Comprehensive Specialized Hospital, 2021-2025 G.C.

Methods: This Institutional-based retrospective comparative cross-sectional study reviewed 222 patient records. Data were analyzed using SPSS version 27. Bivariable logistic regression analysis done and identified candidate variables with p<0.25, entered into multivariable logistic regression to determine independent predictors of surgical outcome. Adjusted odds ratios with 95% CIs were reported. Model fit and multicollinearity were assessed. Statistical significance was set at p<0.05.

Results: Mean age was 26.99±9.1 years; 71.2% were male. Poor outcomes were lower with spinal vs. general anesthesia (11.7% vs. 33.3%, p=0.001), with fewer complications and shorter hospital stay (2.6±1.4 vs. 3.8±2.1 days, p<0.001). Postoperative pain was also lower in the spinal group (p<0.01). Independent predictors of poor outcome were general anesthesia (AOR 7.64), complicated appendicitis (AOR 6.98), ASA II/III (AOR 6.8), and surgery duration >1 hour (AOR 10.4) (all p<0.001).

Conclusion and recommendation: Spinal anesthesia for open appendectomy is associated with superior surgical outcomes compared to general anesthesia. These findings support to recommend Spinal anesthesia use in eligible patients within resource-limited settings.

Keywords: Appendectomy, spinal anesthesia, general anesthesia, surgical outcome