Small-Dose Selective Spinal Anesthesia for Short-Duration Outpatient Laparoscopy: Recovery Characteristics Compared with Desflurane Anesthesia

Abstract

This study compared the use of a desflurane general anesthetic to a small-dose spinal anesthetic in ambulatory gynecological laparoscopy. Using the spinal technique, patients can walk from the operating room table to a stretcher on completion of surgery. Their recovery time was similar to that of the desflurane group.

Optimizing pain management to facilitate Enhanced Recovery After Surgery pathways

“…23 The ''minidose'' spinal technique has been shown to facilitate faster recovery than general anesthesia for short-duration outpatient laparoscopy. 24 Nevertheless, clinicians must be cognizant of the potential side effects of intrathecal opioids, such as PONV, which may delay discharge. This highlights the importance of tailoring analgesic regimens to patient type.…”

Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia d’Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell’Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES)

“…However, the anesthetic technique should be tailored to the type of surgery. General anesthesia (balanced anesthesia technique with several intravenous and inhalational agents and the use of muscle relaxants), peripheral nerve blocks, and neuraxial anesthesia as an alternative to general anesthesia for outpatient pelvic laparoscopy, local anesthesia infiltration in microlaparoscopy for limited and precise gynecological procedures, and intravenous sedation can be used with a safe profile for patients and have been described in the literature (LE 5) [364], (LE 4) [365], (LE 2b) [366,367], (LE 1b) [368], (LE 1a) [369], (LE 4) [370], (LE 1b) [371,372], (LE 2b) [373,374], (LE 1b) [375]. Laparoscopy is most commonly performed with the patient under general anesthesia, especially for prolonged and upper abdominal procedures.…”

A Prospective Randomised Study To Evaluate The Feasibility And Safety of Laparoscopic Cholecystectomy Under Spinal Anaesthesia

“…[8,9] Spinal anaesthesia is a less invasive anaesthetic technique that has lower morbidity and mortality rates, compared with general anesthesia. [10] Furthermore, spinal anaesthesia offers several advantages over general anesthesia. [10] First, the patient is awake and oriented at the end of the procedure.…”

“…[10] Furthermore, spinal anaesthesia offers several advantages over general anesthesia. [10] First, the patient is awake and oriented at the end of the procedure. Second, the immediate postoperative period is viewed positively by patients because of the absence of general anaesthetic side effects (e.g., nausea and vomiting) and less pain experienced due to the effect of persistent neuraxial blockage.…”