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Pelvic floor reconstructive surgery under local anesthesia: A systematic review and meta-analysis
Dimitrios Zacharakis1, Anastasia Prodromidou1, Athanasios Douligeris1
11st Department of Obstetrics & Gynecology, Medical School, National and Kapodistrian University of Athens, "Alexandra" Hospital, Athens, Greece.
Neurourology and Urodynamics
|June 19, 2021
Summary
Local anesthesia (LA) for pelvic floor repair offers improved pain control for up to 18 hours post-surgery compared to general or regional anesthesia. This safe and effective technique promotes faster recovery, especially for stress urinary incontinence procedures.
Area of Science:
- Urogynecology
- Anesthesiology
- Surgical Outcomes
Background:
- Pelvic floor repair anesthesia choice involves patient factors and cost.
- Local anesthesia (LA) is an alternative for urogynecological procedures.
Purpose of the Study:
- To review the literature on urogynecological procedures performed under local anesthesia (LA).
Main Methods:
- Systematic search of four electronic databases up to May 2020.
- Included studies reporting outcomes of women undergoing pelvic floor reconstructive surgery under LA with or without sedation.
Main Results:
- Nineteen studies (1626 cases) were analyzed.
- Meta-analysis showed significantly lower pain scores with LA at 4-18 hours postoperatively compared to general/regional anesthesia (GA/RA).
- Nausea rates were lower in the LA group compared to the RA group 8 hours postoperatively.
Conclusions:
- Local anesthesia (LA) with or without sedation is a safe and effective anesthetic technique for urogynecological procedures.
- LA offers improved pain scores up to 18 hours postoperatively, particularly for stress urinary incontinence (SUI) surgery.
- LA facilitates prompt postoperative recovery and can be offered to patients undergoing pelvic floor surgery.
