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Is local anesthesia an affordable alternative to general anesthesia for minilaparoscopy?
1Ospedale S. Giovanni Calibita Fatebenefratelli, Ple Fatebenefratelli 4, 00186 Rome, Italy.
Study Objective:
To determine if minilaparoscopy under local anesthesia is at least as reliable and affordable as that performed under general anesthesia.
Design:
Prospective, randomized study (Canadian Task Force classification I).
Setting:
University-affiliated hospital.
Patients:
One hundred sixty-four consecutive women evaluated for infertility.
Intervention:
Diagnostic minilaparoscopy performed after women were randomized to receive general or local anesthesia with conscious sedation.
Measurements And Main Results:
Levels of postoperative pain measured by visual analog scale; volume of CO(2) used; length of procedure, complete pelvic evaluation, and hospitalization; complications; and pathologic diagnosis were evaluated. The groups were comparable in age, years of infertility, and symptoms. For women receiving local anesthesia, 5.5% required general anesthesia to complete the procedure. Women in both groups required postoperative analgesics. The groups had no statistically significant differences in pain level 1 hour after the procedure, number of complications, and pelvic pathology. Patients who had local anesthesia required a smaller volume of CO(2) (p <0.01) and their hospitalization was significantly shorter (p <0.01). However, in 15% of these women pelvic visualization was incomplete, compared with 7.2% in the general anesthesia group.
Conclusion:
Minilaparoscopy performed under local anesthesia was as reliable and affordable as when performed under general anesthesia.