Comparison of general anesthesia and combined spinal and epidural
anesthesia for gasless laparoscopic surgery in gynecologic field
Abstract
Objective: This study aimed to compared general anesthesia and combined
spinal and epidural anesthesia (CSEA) for gasless laparoscopic surgery
in gynecologic field. Study design: We matched patients with type of
surgery who underwent gasless single port access (SPA) laparoscopic
surgery under general anesthesia (GA) and CSEA. The medical records of
90 patients between March 2018 and June 2020 were reviewed. Gasless
laparoscopic surgery was performed in all patients with a single-port
access (SPA) using a J-shaped retractor Results: No significant
differences were observed for age, body mass index, parity, and previous
abdominal surgery between GA and CSEA group . During operation under
CSEA, six patients (20%) experienced nausea/vomiting. Hypotension
(systolic blood pressure < 90 mmHg) was observed in five
patients (16.7 %). Intravenous analgesics was administrated in four of
the patients (13.3 %) who suffered from shoulder pain or abdominal
discomfort. One patient developed bradycardia. The duration of hospital
admission was shorter in the CSEA group than in the GA group (p value =
0.014). There was no difference between the groups in terms of surgery
type, surgical specific finding, operation time, estimated blood loss,
laparotomy conversion rate and use of additional trocar. No major
complications such as urologic, bowel, or vessel injuries were found in
both groups. Conclusions: CSEA is a safe and feasible technique for
application in non-obese patients undergoing gasless laparoscopic
surgery in gynecologic field.