Gynecological Laparoscopic Surgeries under Spinal Anesthesia: Benefits and Challenges

Area of Science:

• Anesthesiology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Spinal anesthesia is increasingly explored for various surgical procedures.
• Assessing intraoperative side effects and feasibility is crucial for patient safety and surgical outcomes.

Purpose of the Study:

• To evaluate the feasibility of laparoscopic pelvic surgery under spinal anesthesia.
• To analyze intraoperative side effects such as pain, nausea, and vomiting in 915 patients.

Main Methods:

• Prospective analysis of 915 patients undergoing laparoscopic pelvic surgery under spinal anesthesia.
• Correlation of outcomes with Body Mass Index (BMI), obesity, pain, intra-abdominal CO2 pressure, and surgical complications.

Main Results:

• Higher BMI (>30), adhesions, longer operation duration, bleeding, and increased CO2 pressure were linked to pain.
• Underweight patients experienced less pain with increased intra-abdominal pressure compared to normal weight.
• Pain, nausea, and vomiting occurred in 10.3% of patients, were manageable, and did not impede surgery.

Conclusions:

• Spinal anesthesia is proposed as a primary anesthetic choice for laparoscopic pelvic surgery in eligible patients.
• This study represents the largest clinical dataset on spinal anesthesia for laparoscopic pelvic procedures.