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Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionBackground and Aims Laparoscopic bowel resection is typically performed under general anesthesia (GA), but adjunctive low-dose spinal anesthesia (LSA) may offer superior perioperative analgesia and reduce opioid requirements, potentially enhancing postoperative recovery. This study aimed to compare standard GA with GA plus LSA in terms of perioperative opioid consumption and pain control for patients undergoing laparoscopic bowel resection.Methods We conducted an observational study of 26 consecutive patients undergoing laparoscopic bowel resection at our institution between August and December 2024. Institutional ethical approval was obtained. Patients were divided into two groups: those receiving standard GA with intraoperative fentanyl and peripheral analgesics (n=20), and those receiving GA combined with LSA with intrathecal bupivacaine (7.5 mg) and fentanyl (25 mcg) (n=6). Both groups received postoperative analgesia with piritramide PCA, paracetamol, and metamizole. In the post-anesthesia care unit (PACU), mean Visual Analog Scale (VAS) pain scores and piritramide consumption were analyzed. Postoperative outcomes—including daily average VAS, piritramide bolus requests, and complications (PONV, pruritus, ileus)—were monitored for two days. Statistical analysis was performed using Python, employing t-tests for normally distributed data and Mann-Whitney U tests for non-parametric data.Results Demographic characteristics and procedure duration were comparable between groups. The GA plus LSA group demonstrated significantly lower mean VAS scores (p=0.007) and reduced piritramide consumption (p=0.007) in the PACU. On the second postoperative day, the GA plus LSA group required fewer piritramide boluses (p=0.001). There were no significant differences in complication rates.Conclusions Combining GA with low-dose spinal anesthesia significantly reduces perioperative opioid consumption and pain scores in laparoscopic bowel resection, with no increase in complications. These findings suggest a potential role for combined anesthesia in optimizing postoperative outcomes, but larger, prospective studies are warranted to confirm and extend these results.