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Comparison of general anesthesia and combined spinal and epidural anesthesia for gasless laparoscopic surgery in gynecologic field
  • Jong Ha Hwang,
  • Bo Wook Kim
Jong Ha Hwang
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Bo Wook Kim
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Abstract

Objective: This study aimed to compared general anesthesia and combined spinal and epidural anesthesia (CSEA) for gasless laparoscopic surgery in gynecologic field. Study design: We matched patients with type of surgery who underwent gasless single port access (SPA) laparoscopic surgery under general anesthesia (GA) and CSEA. The medical records of 90 patients between March 2018 and June 2020 were reviewed. Gasless laparoscopic surgery was performed in all patients with a single-port access (SPA) using a J-shaped retractor Results: No significant differences were observed for age, body mass index, parity, and previous abdominal surgery between GA and CSEA group . During operation under CSEA, six patients (20%) experienced nausea/vomiting. Hypotension (systolic blood pressure < 90 mmHg) was observed in five patients (16.7 %). Intravenous analgesics was administrated in four of the patients (13.3 %) who suffered from shoulder pain or abdominal discomfort. One patient developed bradycardia. The duration of hospital admission was shorter in the CSEA group than in the GA group (p value = 0.014). There was no difference between the groups in terms of surgery type, surgical specific finding, operation time, estimated blood loss, laparotomy conversion rate and use of additional trocar. No major complications such as urologic, bowel, or vessel injuries were found in both groups. Conclusions: CSEA is a safe and feasible technique for application in non-obese patients undergoing gasless laparoscopic surgery in gynecologic field.