TY - JOUR
T1 - Laparoscopic Gynecologic Surgery Under Regional Neuraxial Anesthesia
AU - Landi, Stefano
AU - Cacozza, Daniel
AU - Fumero, Elisabetta
AU - Castellacci, Eleonora
AU - Forasassi, Lorenzo
AU - Terradura, Lucrezia
AU - Mannini, Carlo Alberto
AU - Tommasini, Luca
AU - Remorgida, Valentino
N1 - Publisher Copyright:
ª Mary Ann Liebert, Inc.
PY - 2024/8/1
Y1 - 2024/8/1
N2 - Objectives: Commonly, general anesthesia (GA) with endotracheal intubation is the standard anesthesiology approach in gynecological laparoscopic surgery; neuraxial anesthesia (NA) can also be used, but its application is very low and limited to few indications. This study assessed NA feasibility for almost all kinds of gynecologic laparoscopies. Materials and Methods: Data on laparoscopic surgeries performed under NA were collected retrospectively. A total of 76 patients had laparoscopic interventions at the Donatello Clinic in Florence, Italy, between October 2019 and August 2022. Adnexectomies, ovarian cyst enucleations, multiple myomectomies, total hysterectomies, radical hysterectomies with sentinel lymph-node biopsies, and complete excisions of endometriosis and adhesiolysis were performed under regional anesthesia. All procedures but 1 were completed with no change from NA. Results: All cases but 1 were completed under NA. There were (1) spontaneously breathing patients; (2) no pulmonary complications; (3) satisfactory muscle relaxation; (4) fast postoperative bowel function recovery; (5) reduced postoperative pain; (6) reduced postoperative narcotics use; and (6) absence of postoperative nausea and vomiting. Conclusions: These procedures appear to comprise the largest series of complex gynecologic laparoscopies performed under NA reported in the literature. Preliminary data seems to support the concept that this approach might be feasible and safe in selected and motivated patients, but further research is needed to confirm these encouraging data.
AB - Objectives: Commonly, general anesthesia (GA) with endotracheal intubation is the standard anesthesiology approach in gynecological laparoscopic surgery; neuraxial anesthesia (NA) can also be used, but its application is very low and limited to few indications. This study assessed NA feasibility for almost all kinds of gynecologic laparoscopies. Materials and Methods: Data on laparoscopic surgeries performed under NA were collected retrospectively. A total of 76 patients had laparoscopic interventions at the Donatello Clinic in Florence, Italy, between October 2019 and August 2022. Adnexectomies, ovarian cyst enucleations, multiple myomectomies, total hysterectomies, radical hysterectomies with sentinel lymph-node biopsies, and complete excisions of endometriosis and adhesiolysis were performed under regional anesthesia. All procedures but 1 were completed with no change from NA. Results: All cases but 1 were completed under NA. There were (1) spontaneously breathing patients; (2) no pulmonary complications; (3) satisfactory muscle relaxation; (4) fast postoperative bowel function recovery; (5) reduced postoperative pain; (6) reduced postoperative narcotics use; and (6) absence of postoperative nausea and vomiting. Conclusions: These procedures appear to comprise the largest series of complex gynecologic laparoscopies performed under NA reported in the literature. Preliminary data seems to support the concept that this approach might be feasible and safe in selected and motivated patients, but further research is needed to confirm these encouraging data.
KW - endoscopic surgery
KW - general anesthesia
KW - laparoscopy
KW - neuraxial anesthesia
KW - postoperative nausea and vomiting
KW - visual analogue scale
UR - http://www.scopus.com/inward/record.url?scp=85188936187&partnerID=8YFLogxK
U2 - 10.1089/gyn.2023.0104
DO - 10.1089/gyn.2023.0104
M3 - Article
SN - 1042-4067
VL - 40
SP - 244
EP - 247
JO - Journal of Gynecologic Surgery
JF - Journal of Gynecologic Surgery
IS - 4
ER -