Comparison of patient satisfaction with thoracic segmental spinal anaesthesia with modified tumescent solution vs general anaesthesia with standard tumescent solution for liporeduction of gynecomastia: A Randomized controlled trial

Gynecomastiais a most common condition affecting male breast due to enlargement of bothductal and stromal tissue. Corrective surgery is the only solution for longstanding gynecomastia, and it includes open excision, conventional liposuction,or combination of these if required under local (tumescent) or generalanaesthesia. Segmental spinal anaesthesia (SSA) to block only the thoracicsegments can also be given for breast surgeries and there are numerousadvantages such as Avoidance of airway manipulation, polypharmacy, lesser risk ofPONV, lesser chances of hypotension, able to achieve adequate muscle relaxationwithout respiratory or circulatory depression. Using modified tumescentsolution (removing lignocaine and bupivacaine) we can eliminate the possibilityof Local anaesthesia systemic toxicity (LAST) while analgesia will be providedby SSA. Our Primary objective is to compare the patient satisfaction of usingSSA vs GA in patients undergoing liporeduction for gynecomastia surgeries andour secondary Objectives are to assess and compare the surgeon satisfaction ofusing SSA vs GA in patients undergoing liporeduction for gynecomastia surgeries,to compare the incidence of PONV among both the groups and to compare theincidence of hemodynamic variations among the groups. This is a pilot study, where we want tofind the feasibility of using the modified tumescent solution. We will include20 patients in SSA and 20 patients in GA group. Hence, we would like tocompare patient satisfaction with thoracic segmental spinal Anaesthesia usingmodified tumescent solution vs General Anaesthesia using standard tumescentsolution for liporeduction of gynecomastia.