Spinal Anesthesia versus General Anesthesia in Gynecological Laparoscopic Surgery: A Systematic Review and Meta-Analysis

Corte, Luigi Della; Mercorio, Antonio; Morra, Ilaria; Riemma, Gaetano; Franciscis, Pasquale De; Palumbo, Mario; Viciglione, Francesco; Borrelli, Danilo; Laganà, Antonio Simone; Vizzielli, Giuseppe; Bifulco, Giuseppe; Giampaolino, Pierluigi

doi:10.1159/000521364

Cited by 15 publications

(18 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our data confirm the suitability of laparoscopy surgery under RA for gynecological surgery, a still debated subject in literature, in contrast to general surgery of which successful results are already reported in literature [ 14 – 18 ].…”

Section: Discussionsupporting

confidence: 87%

See 1 more Smart Citation

Laparoscopic gynecological surgery under minimally invasive anesthesia: a prospective cohort study

et al. 2022

Self Cite

View full text Add to dashboard Cite

The purpose of this study is to assess the feasibility and the perioperative outcomes of laparoscopic gynecological surgery in regional anesthesia (RA) from the point of view of the surgeon, anesthesiologist and patient. This is a prospective cohort study comprising sixty-six women planned to undergo gynecologic laparoscopy surgery for benign pathology at tertiary care gynecolgical center of the University Federico II of Naples. Women were assigned, according to their preference, to either RA (Group A) or general anesthesia (GA) (Group B). Surgical, anesthesiologic and postoperative recovery data were recorded. Postoperative pain was considered as the primary outcome. Secondary outcomes included mobilization, length of hospital stay, global surgeons and patient satisfaction, intraoperative pain assessment in Group A. Immediate postoperative pain was significantly lower in Group A 0 vs 2 (p < 0.001), with no significant differences at 24 h. The secondary outcome demonstrated early patient’s mobilization (p < 0.001) as well as early discharge (p < 0.001) and greater patient’s satisfaction for the Group A. In these patients, a maximum pain score of 3 points out of 5 was recorded through the entire surgery. RA showed to decrease the impact of surgical stress and to guarantee a quicker recovery without compromising surgical results. Although several surgical approaches can be employed to treat different conditions, RA technique could be a viable option for well-selected patients affected by gynecological diseases.

show abstract

Section: Discussionsupporting

confidence: 87%

“…Only one case report on total laparoscopic hysterectomy is reported in the literature [ 13 ]. Recently, a review by Della Corte et al has shown no significant advantages to using SA over GA for laparoscopic treatment of gynecological diseases [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic gynecological surgery under minimally invasive anesthesia: a prospective cohort study

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…These findings were comparable to the previous studies. [10,11]Among both groups paratubal cystectomy was most common symptom found in 6 (13.3%) cases and 7 (15.6%) cases. Mean operative time in neuroaxial group was lower 45.3±6.52 minutes as compared to group II was 54.8±11.42 minutes.…”

Section: Discussionmentioning

confidence: 94%

Neuroaxial Verses General Anesthesia for Gynecological Surgeries

Hiranand¹,

Salman²,

Sattar³

et al. 2022

PJMHS

View full text Add to dashboard Cite

Objective: To evaluate the anaesthetic effects, patient satisfaction, and the Oxidative Stress Index between neuroaxial anaesthesia (NA) and general anaesthesia (GA) during gynecologic laparoscopic surgery. Study Design: Prospective randomized study Place and Duration: Lady Reading Hospital Peshawar.1st Jan, 2021 to 30 June, 2021. Methods: The research involved ninety women between the ages of 20 and 55 who were scheduled to undergo diagnostic laparoscopy and hysteroscopy for unexplained infertility and had an ASA I-II physical status.Age, BMI and laparotomy indication were documented after obtaining informed written permission from each patient. Patients were equally divided in two groups group I received neuroaxial anesthesia and group II received general anesthesia. Post-operative outcomes among both groups were compared. SPSS 22.0 was used to analyze complete data. Results:Mean age of the patients in group I was 33.4±11.32 years and had mean BMI 25.4±7.81 kg/m2 while in group II mean age was 30.7±14.63 years with mean BMI 22.8±9.52 kg/m2. In group I 28 (62.2%) cases had ASA class I and in group II 30 (66.7%) cases had ASA class I. Diagnostic laparoscopy was majority in numbers among both groups 29 (64.4%) in group I and 26 (57.8%) in group II. Among both groups paratubal cystectomy was most common symptom found in 6 (13.3%) cases and 7 (15.6%) cases. Mean operative time in neuroaxial group was lower 45.3±6.52 minutes as compared to group II was 54.8±11.42 minutes. Mean time of anesthesia was also lower in group I as compared to group II with p value <0.003. Mean pain score was significantly reduced in group I 3.6±8.61 as compared to group II 6.8±11.92. Heart rate and arterial pressure was lower in group I. Post-operative Oxidative Stress index among patients of group II was higher 1.9±4.45 as compared to group I 0.9±0.42. Conclusion:We concluded in this study that the use of neuroaxial anesthesia undergoing gynecologica laparoscopy was effective and useful as compared to general anesthesia in terms of less pain score and oxidative stress index. Except this frequency of adverse events were also lower in neuroaxial group. Keywords: Laparoscopy, Nueroaxial Anesthesia, General Anesthesia, Complication, Pain score

show abstract

“…The results of this case series provide the indication that RA could be considered a valid alternative to GA, not only for minimally invasive and short-term gynecological procedures [ 31 ], but even for longer and more complex gynecological surgery such as hysterectomy procedure. This represents a convincing result, especially if it is considered that a recent review with meta-analysis has demonstrated no significant advantages to using SA over GA for laparoscopic treatment of benign gynecological diseases [ 32 ]. On the other hand, a prospective study published by the same Group has reported how RA could be a viable option for well-selected patients affected by benign gynecological diseases [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive anesthesia for laparoscopic hysterectomy: a case series

Corte

Mercorio

Palumbo

et al. 2022

Arch Gynecol Obstet

Self Cite

View full text Add to dashboard Cite

Purpose Regional anesthesia (RA) is considered as a “minimally invasive technique” to achieve anesthesia. To assess the feasibility and the perioperative outcomes of laparoscopic hysterectomy in regional anesthesia from the point of view of the surgeon, anesthesiologist and patient. Methods A retrospective search was performed to identify patients who underwent laparoscopic hysterectomy under RA from April 2020 to September 2021. Five patients affected by benign gynecological disease (atypical endometrial hyperplasia or uterine leiomyomas) were included. Results The postoperative pain, nausea, and vomiting (PONV) and the antiemetic/analgesic intake were evaluated. Postoperative surgical and anesthesiological variables were recorded. Duration of surgery was 84 ± 4.18 and no conversion to GA was required. According to VAS score, the postoperative pain during the whole observation time was less than 4 (median). A faster resumption of bowel motility (≤ 9 h) and patient’s mobilization (≤ 4 h) were observed as well as a low incidence of post-operative nausea and vomit. Early discharge and greater patient’s satisfaction were recorded. Intraoperatively pain score was assessed on Likert scale during all the stages of laparoscopy in RA, with only 2 patients complaining scarce pain (= 2) at pneumoperitoneum. Conclusion RA showed to have a great impact on surgical stress and to guarantee a quicker recovery without compromising surgical results. RA technique could be a viable option for patients undergoing laparoscopic hysterectomy.

show abstract

Spinal Anesthesia versus General Anesthesia in Gynecological Laparoscopic Surgery: A Systematic Review and Meta-Analysis

Cited by 15 publications

References 18 publications

Laparoscopic gynecological surgery under minimally invasive anesthesia: a prospective cohort study

Laparoscopic gynecological surgery under minimally invasive anesthesia: a prospective cohort study

Neuroaxial Verses General Anesthesia for Gynecological Surgeries

Minimally invasive anesthesia for laparoscopic hysterectomy: a case series

Contact Info

Product

Resources

About