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2020 ; 49
(7
): 101813
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Laparoscopic surgery for benign adnexal conditions under spinal anaesthesia:
Towards a multidisciplinary minimally invasive approach
#MMPMID32426576
Raimondo D
; Borghese G
; Mastronardi M
; Mabrouk M
; Salucci P
; Lambertini A
; Casadio P
; Tonini C
; Meriggiola MC
; Arena A
; Tarozzi G
; Seracchioli R
J Gynecol Obstet Hum Reprod
2020[Sep]; 49
(7
): 101813
PMID32426576
show ga
BACKGROUND: Laparoscopic gynaecological surgery is commonly performed under
general anaesthesia with endotracheal intubation. In general surgery,
locoregional anaesthesia was applied to laparoscopic procedures, increasing
minimally invasive surgery advantages. AIMS: To assess and compare postoperative
pain after laparoscopic adnexal procedures for benign conditions under spinal
anaesthesia (SA) versus general anaesthesia (GA). Furthermore, anaesthesiologic,
surgical and clinical data were evaluated in both groups. MATERIALS AND METHODS:
This is a prospective cohort study performed in a tertiary level referral centre
for minimally invasive gynaecological surgery (Gynaecology and Human Reproduction
Physiopathology, University of Bologna). Women scheduled for adnexal laparoscopic
surgery for benign conditions between February and May 2019 were assigned to
receive either SA or GA with endotracheal intubation. A sample size of 13 women
per group was needed to detect a 2-point difference in pain scores. MAIN
FINDINGS: 13 women were enrolled in the SA arm, 15 in the GA arm. In the SA
cohort, the most common intraoperative adverse event was shoulder pain, reported
by 3/12 women. At 1, 8, 12, 24 and 48 h after surgery pain was significantly
lower in the SA arm (p < .05). Patients submitted to SA experienced no need for
opioid drugs administration, unlike those receiving GA. Patients' mobilization
and return of bowel function were noted significantly earlier in the SA group (p
< .05). CONCLUSIONS: SA is a feasible, safe and effective anaesthesiologic
technique for laparoscopic gynaecological procedures for benign conditions,
allowing a better control of postoperative pain. Women undergoing SA achieve
earlier mobilization and bowel canalization. During the Covid-19 pandemics, SA
could be useful in reducing the need for invasive procedures on respiratory
tract.